Hemolysis during short-term mechanical circulatory support: from pathophysiology to diagnosis and treatment

References

• Chioncel O, Parissis J, and Mebazaa A, et al. Epidemiology, pathophysiology and contemporary management of cardiogenic shock - a position statement from the heart failure association of the European society of cardiology. Eur J Heart Fail. 2020 Aug;22(8):1315–1341.
   PubMed Web of Science ®Google Scholar
• Thiele H, Zeymer U, Neumann FJ, et al. IABP-SHOCK II trial investigators. Intraaortic balloon support for myocardial infarction with cardiogenic shock. N Engl J Med. 2012 Oct 4;367(14):1287–1296.
   PubMed Web of Science ®Google Scholar
• Dhruva SS, Ross JS, Mortazavi BJ, et al. Association of use of an intravascular microaxial left ventricular assist device vs intra-aortic balloon pump with in-hospital mortality and major bleeding among patients with acute myocardial infarction complicated by cardiogenic shock. JAMA. 2020 Feb 25;323(8):734–745.
   PubMed Web of Science ®Google Scholar
• Schrage B, Ibrahim K, Loehn T, et al. Impella support for acute myocardial infarction complicated by cardiogenic shock. Circulation. 2019 Mar 5;139(10):1249–1258.
   PubMed Web of Science ®Google Scholar
• Basir MB, Kapur NK, Patel K, et al. National cardiogenic shock initiative investigators. Improved outcomes associated with the use of shock protocols: updates from the national cardiogenic shock initiative. Catheter Cardiovasc Interv. 2019 Jun 1;93(7):1173–1183.
   PubMed Web of Science ®Google Scholar
• Balthazar T, Vandenbriele C, and Verbrugge FH, et al. Managing patients with short-term mechanical circulatory support. J Am Coll Cardiol. 2021 Mar 9;77(9):1243–1256.
   PubMed Web of Science ®Google Scholar
• Ramzy D, Anderson M, Batsides G, et al. Early outcomes of the first 200 US patients treated with Impella 5.5: a novel temporary left ventricular assist device. Innovations (Phila). 2021 Jul-Aug;16(4):365–372.
   PubMedGoogle Scholar
• Pieri M, Sorrentino T, Oppizzi M, et al. The role of different mechanical circulatory support devices and their timing of implantation on myocardial damage and mid-term recovery in acute myocardial infarction related cardiogenic shock. J Interv Cardiol. 2018 Dec;31(6):717–724.
   PubMed Web of Science ®Google Scholar
• Ravichandran AK, Parker J, Novak E, et al. Hemolysis in left ventricular assist device: a retrospective analysis of outcomes. J Heart Lung Transplant. 2014 Jan;33(1):44–50.
   PubMed Web of Science ®Google Scholar
• Katz JN, Jensen BC, Chang PP, et al. A multicenter analysis of clinical hemolysis in patients supported with durable, long-term left ventricular assist device therapy. J Heart Lung Transplant. 2015 May;34(5):701–709.
   PubMed Web of Science ®Google Scholar
• Ouweneel DM, Eriksen E, Sjauw KD, et al. Percutaneous mechanical circulatory support versus intra-aortic balloon pump in cardiogenic shock after acute myocardial infarction. J Am Coll Cardiol. 2017 Jan 24;69(3):278–287.
   PubMed Web of Science ®Google Scholar
• Tehrani BN, Truesdell AG, Sherwood MW, et al. Standardized team-based care for cardiogenic shock. J Am Coll Cardiol. 2019 Apr 9;73(13):1659–1669.
   PubMed Web of Science ®Google Scholar
• Ouweneel DM, de Brabander J, Karami M, et al. Real-life use of left ventricular circulatory support with Impella in cardiogenic shock after acute myocardial infarction: 12 years AMC experience. Eur Heart J Acute Cardiovasc Care. 2019 Jun;8(4):338–349.
   PubMed Web of Science ®Google Scholar
• Monteagudo Vela M, Simon A, Riesgo Gil F, et al. Clinical indications of Impella short-term mechanical circulatory support in a tertiary centre. Cardiovasc Revasc Med. 2020 May;21(5):629–637.
   PubMed Web of Science ®Google Scholar
• Chieffo A, Ancona MB, Burzotta F, et al. Observational multicentre registry of patients treated with IMPella mechanical circulatory support device in Italy: the IMP-IT registry. EuroIntervention. 2020 Feb 7;15(15):e1343–e1350.
   PubMed Web of Science ®Google Scholar
• Karami M, den Uil CA, Ouweneel DM, et al. Mechanical circulatory support in cardiogenic shock from acute myocardial infarction: impella CP/5.0 versus ECMO. Eur Heart J Acute Cardiovasc Care. 2020 Mar;9(2):164–172.
   PubMed Web of Science ®Google Scholar
• Lemor A, Hosseini Dehkordi SH, Basir MB, et al. Impella versus extracorporeal membrane oxygenation for acute myocardial infarction cardiogenic shock. Cardiovasc Revasc Med. 2020 Dec;21(12):1465–1471.
   PubMed Web of Science ®Google Scholar
• Loehn T, O’Neill WW, Lange B, et al. Long term survival after early unloading with Impella CP in acute myocardial infarction complicated by cardiogenic shock. Eur Heart J Acute Cardiovasc Care. 2020 Mar;9(2):149–157.
   PubMed Web of Science ®Google Scholar
• Rock JR, Kos CA, Lemaire A, et al. Single center first year experience and outcomes with Impella 5.5 left ventricular assist device. J Cardiothorac Surg. 2022 May 23;17(1):124.
   PubMed Web of Science ®Google Scholar
• Toda K, Ako J, Hirayama A, et al. J.-PVAD registry study investigators. Three-year experience of catheter-based micro-axial left ventricular assist device, Impella, in Japanese patients: the first interim analysis of Japan registry for percutaneous ventricular assist device (J-PVAD). J Artif Organs. 2022 Apr 25. DOI:10.1007/s10047-022-01328-1.
   Web of Science ®Google Scholar
• Cannata A, Cantoni S, Sciortino A, et al. Mechanical hemolysis complicating transcatheter interventions for valvular heart disease: JACC state-of-the-art review. J Am Coll Cardiol. 2021 May 11;77(18):2323–2334.
   PubMed Web of Science ®Google Scholar
• Yasuda T, Shimokasa K, Funakubo A, et al. An investigation of blood flow behavior and hemolysis in artificial organs. ASAIO J. 2000 Sep-Oct;46(5):527–531.
   PubMed Web of Science ®Google Scholar
• Köhne I. Haemolysis induced by mechanical circulatory support devices: unsolved problems. Perfusion. 2020 Sep;35(6):474–483.
   PubMed Web of Science ®Google Scholar
• Roberts N, Chandrasekaran U, Das S, et al. Hemolysis associated with Impella heart pump positioning: in vitro hemolysis testing and computational fluid dynamics modeling. Int J Artif Organs. 2020 Mar;4:391398820909843.
   Google Scholar
• de Biasi AR, Manning KB, Salemi A. Science for surgeons: understanding pump thrombogenesis in continuous-flow left ventricular assist devices. J Thorac Cardiovasc Surg. 2015 Mar;149(3):667–673.
   PubMed Web of Science ®Google Scholar
• Papanastasiou CA, Kyriakoulis KG, Theochari CA, et al. Comprehensive review of hemolysis in ventricular assist devices. World J Cardiol. 2020 Jul 26; 12(7):334–341.
   PubMed Web of Science ®Google Scholar
• Chow TW, Hellums JD, Moake JL, et al. Shear stress-induced von Willebrand factor binding to platelet glycoprotein Ib initiates calcium influx associated with aggregation. Blood. 1992 Jul 1; 80(1):113–120.
   PubMed Web of Science ®Google Scholar
• Ataga KI. Hypercoagulability and thrombotic complications in hemolytic anemias. Haematologica. 2009 Nov;94(11):1481–1484.
   PubMed Web of Science ®Google Scholar
• Qian Q, Nath KA, Wu Y, et al. Hemolysis and acute kidney failure. Am J Kidney Dis. 2010;56(4):780–784.
   PubMed Web of Science ®Google Scholar
• Concepcion B, Korbet SM, Schwartz MM. Intravascular hemolysis and acute renal failure after mitral and aortic valve repair. Am J Kidney Dis. 2008 Nov;52(5):1010–1015.
   PubMed Web of Science ®Google Scholar
• Nakamura M, Imamura T, Fukui T, et al. Impact of the angle between aortic and mitral annulus on the occurrence of hemolysis during Impella support. J Artif Organs. 2020 Sep;23(3):207–213.
   PubMed Web of Science ®Google Scholar
• Lazicki TJ, Pagel PS. Reduced flow rate, acute hemolysis, and restricted anterior mitral leaflet opening during mechanical circulatory support for end-stage nonischemic cardiomyopathy. J Cardiothorac Vasc Anesth. 2020 Feb;34(2):562–565.
   PubMed Web of Science ®Google Scholar
• Elhussein TA, Hutchison SJ. Acute mitral regurgitation: unforeseen new complication of the Impella LP 5.0 ventricular assist device and review of literature. Heart Lung Circ. 2014 Mar;23(3):e100–4.
   PubMed Web of Science ®Google Scholar
• Lüsebrink E, Massberg S, Orban M. Combined extracorporeal membrane oxygenation and microaxial pump-when left ventricular preload is too low to unload in cardiogenic shock. Health Sci Rep. 2021 Jul 9;4(3):e321.
   PubMedGoogle Scholar
• Aoun J, Tea I, Bhimaraj A, et al. Refractory Impella suction alarms in the setting of extracorporeal membrane oxygenation. CJC Open. 2021 May 2;3(9):1186–1188.
   PubMedGoogle Scholar
• Whitehead EH, Thayer KL, Burkhoff D, et al. Central venous pressure and clinical outcomes during left-sided mechanical support for acute myocardial infarction and cardiogenic shock. Front Cardiovasc Med. 2020 Aug 28;7:155.
   PubMed Web of Science ®Google Scholar
• Ranc S, Sibellas F, Green L. Acute intraventricular thrombosis of an impella LP 5.0 device in an ST-elevated myocardial infarction complicated by cardiogenic shock. J Invasive Cardiol. 2013 Jan;25(1):E1–3.
   PubMed Web of Science ®Google Scholar
• Nguyen D, Ellison D, Ngo C, et al. Intraventricular free-floating thrombus in an Impella-supported patient: damage control in a no-win scenario. JACC Case Rep. 2020 Jun 17;2(6):886–888.
   PubMedGoogle Scholar
• Nakao Y, Aono J, Namiguchi K, et al. Usefulness of contrast computed tomography for diagnosing left ventricular thrombus before impella insertion. J Cardiol Cases. 2020 Aug 22; 22(6):291–293.
   PubMedGoogle Scholar
• Esposito ML, Morine KJ, and Annamalai SK, et al. Increased plasma-free hemoglobin levels identify hemolysis in patients with cardiogenic shock and a trans valvular micro-axial flow pump. Artif Organs. 2019 Feb;43(2):125–131.
   PubMed Web of Science ®Google Scholar
• Pagani FD, Miller LW, Russell SD, et al. HeartMate II investigators. Extended mechanical circulatory support with a continuous-flow rotary left ventricular assist device. J Am Coll Cardiol. 2009 Jul 21; 54(4):312–321.
   PubMed Web of Science ®Google Scholar
• Wang S, Griffith BP, Wu ZJ. Device-induced hemostatic disorders in mechanically assisted circulation. Clin Appl Thromb Hemost. 2021 Jan-Dec;27:1076029620982374.
   Web of Science ®Google Scholar
• Omar HR, Mirsaeidi M, Socias S, et al. Plasma free hemoglobin is an independent predictor of mortality among patients on extracorporeal membrane oxygenation support. PLoS One. 2015 Apr 22;10(4):e0124034.
   PubMed Web of Science ®Google Scholar
• Pan KC, McKenzie DP, Pellegrino V, et al. The meaning of a high plasma free haemoglobin: retrospective review of the prevalence of haemolysis and circuit thrombosis in an adult ECMO centre over 5 years. Perfusion. 2016 Apr;31(3):223–231.
   PubMed Web of Science ®Google Scholar
• Tchantchaleishvili V, Sagebin F, Ross RE, et al. Evaluation and treatment of pump thrombosis and hemolysis. Ann Cardiothorac Surg. 2014;3(5):490–495.
   PubMedGoogle Scholar
• Da Q, Teruya M, Guchhait P, et al. Free hemoglobin increases von Willebrand factor-mediated platelet adhesion in vitro: implications for circulatory devices. Blood. 2015 Nov 12;126(20):2338–2341.
   PubMed Web of Science ®Google Scholar
• Quevedo HC, Abi Rafeh N. Impella-induced left ventricular microbubbles, a potential sign for hemolysis. J Invasive Cardiol. 2020 Apr;32(4):E101.
   PubMed Web of Science ®Google Scholar
• Ouweneel DM, Sjauw KD, Wiegerinck EM, et al. Assessment of cardiac device position on supine chest radiograph in the ICU: introduction and applicability of the aortic valve location ratio. Crit Care Med. 2016 Oct;44(10):e957–63.
   PubMed Web of Science ®Google Scholar
• Tarabichi S, Ikegami H, Russo MJ, et al. The role of the axillary Impella 5.0 device on patients with acute cardiogenic shock. J Cardiothorac Surg. 2020 Aug 14;15(1):218.
   PubMed Web of Science ®Google Scholar
• Esposito ML, Jablonski J, Kras A, et al. Maximum level of mobility with axillary deployment of the Impella 5.0 is associated with improved survival. Int J Artif Organs. 2018 Apr;41(4):236–239.
   PubMed Web of Science ®Google Scholar
• Garan AR, Kanwar M, Thayer KL, et al. Complete hemodynamic profiling with pulmonary artery catheters in cardiogenic shock is associated with lower in-hospital mortality. JACC Heart Fail. 2020 Nov;8(11):903–913.
   PubMed Web of Science ®Google Scholar
• Osman M, Syed M, Patel B, et al. Invasive hemodynamic monitoring in cardiogenic shock is associated with lower in-hospital mortality. J Am Heart Assoc. 2021 Sep 21;10(18):e021808.
   PubMed Web of Science ®Google Scholar
• Chieffo A, Dudek D, and Hassager C, et al. Joint EAPCI/ACVC expert consensus document on percutaneous ventricular assist devices. Eur Heart J Acute Cardiovasc Care. 2021 Jun 30;10(5):570–583.
   PubMed Web of Science ®Google Scholar
• Nakamura M, Imamura T, Ueno H, et al. Impact of the whole activated clotting time during Impella support on short-term prognosis. J Artif Organs. 2022 Mar;25(1):9–15.
   PubMed Web of Science ®Google Scholar
• Vandenbriele C, Dannenberg L, Monteagudo-Vela M, et al. Optimal antithrombotic regimen in patients with cardiogenic shock on ImpellaTM mechanical support: less might be more. Eur Heart J. 2020 Nov;41(Supplement_2):ehaa946.1843.
   Google Scholar
• Fabrizio C, Levito MN, Rivosecchi R, et al. Outcomes of systemic anticoagulation with bivalirudin for Impella 5.0. Int J Artif Organs. 2021 Oct;44(10):681–686.
   PubMed Web of Science ®Google Scholar
• Blum EC, Martz CR, Selektor Y, et al. Anticoagulation of percutaneous ventricular assist device using argatroban-based purge solution: a case series. J Pharm Pract. 2018 Oct;31(5):514–518.
   PubMed Web of Science ®Google Scholar
• Hohlfelder B, Militello MA, Tong MZ, et al. Anticoagulation with temporary Impella device in patients with heparin-induced thrombocytopenia: a case series. Int J Artif Organs. 2021 May;44(5):367–370.
   PubMed Web of Science ®Google Scholar
• Al-Ayoubi AM, Bhavsar K, Hobbs RA, et al. Use of sodium bicarbonate purge solution in impella devices for heparin-induced thrombocytopenia. J Pharm Pract. 2022 April;089719002210890. DOI:10.1177/08971900221089078.
   Web of Science ®Google Scholar
• Elsherif A, Nadir A, Ludman PF, et al. Retrieval of entrapped catheter-mounted axial flow pump from mitral subvalvular apparatus using a snare catheter. JACC: Case Reports. 2021 Oct 6;3(13):1494–1498.
   PubMedGoogle Scholar
• Alaiti MA, Elby MA, Lang K, et al. Percutaneous repositioning of impella mechanical circulatory support device: snare-direct-push technique. Cardiovasc Revasc Med. 2020 Nov;21(11S):103–104.
   PubMedGoogle Scholar
• Sorensen EN, Carla Williams P, Tabatabai A. Use of tissue plasminogen activator to resolve high purge system pressure in a catheter-based ventricular-assist device. J Heart Lung Transplant. 2014 Apr;33(4):457–458.
   PubMed Web of Science ®Google Scholar
• Succar L, Donahue KR, Varnado S, et al. Use of tissue plasminogen activator alteplase for suspected impella thrombosis. Pharmacotherapy. 2020 Feb;40(2):169–173.
   PubMed Web of Science ®Google Scholar
• Salas de Armas I, Bergeron A, Bhardwaj A, et al. Surgically implanted Impella device for patients on Impella CP support experiencing refractory hemolysis. ASAIO J. 2022 Mar 18. DOI:10.1097/MAT.0000000000001712.
   Google Scholar
• Zager RA, Gamelin LM. Pathogenetic mechanisms in experimental hemoglobinuric acute renal failure. Am J Physiol. 1989 Mar;256(3 Pt 2):F446–55.
   PubMedGoogle Scholar
• Gleason TG, Argenziano M, Bavaria JE, et al. Hemoadsorption to reduce plasma-free hemoglobin during cardiac surgery: results of refresh I pilot study. Semin Thorac Cardiovasc Surg. 2019;31(4):783–793. Winter.
   PubMed Web of Science ®Google Scholar
• Zhigalov K, Van den Eynde J, Zubarevich A, et al. Initial experience with CytoSorb therapy in patients receiving left ventricular assist devices. Artif Organs. 2022 Jan;46(1):95–105.
   PubMed Web of Science ®Google Scholar
• Jackson R, Trus RM, El-Diasty M. Hemadsorption for removal of ticagrelor and direct oral anticoagulants in cardiac surgery. Expert Rev Cardiovasc Ther. 2022 Feb;20(2):141–150.
   PubMed Web of Science ®Google Scholar
• Hayes C, Shafi H, Mason H, et al. Successful reduction of plasma free-hemoglobin using therapeutic plasma exchange: a case report. Transfus Apher Sci. 2016 Apr;54(2):253–255.
   PubMed Web of Science ®Google Scholar
• Alkhouli M, Farooq A, Go RS, et al. Cardiac prostheses-related hemolytic anemia. Clin Cardiol. 2019 Jul;42(7):692–700.
   PubMed Web of Science ®Google Scholar
• Jennings DL, Williams CT, Morgan JA. Pentoxifylline for the treatment of hemolytic anemia in a patient who developed recurrent gastrointestinal bleeding while on continuous-flow left ventricular assist device support. ASAIO J. 2013 Sep-Oct;59(5):526–527.
   PubMed Web of Science ®Google Scholar