RCIS Intra-Aortic Balloon Pump and Mechanical Circulatory Support 3

Question 1

Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides support by:

Accepted Answer

Draining venous blood, oxygenating it extracorporeally, and returning it to the arterial system

Answer

VA-ECMO drains deoxygenated blood from the venous circulation, oxygenates it through a membrane oxygenator, and returns it to the arterial circulation, providing both cardiac and respiratory support.

Question 2

In patients on VA-ECMO, a complication called 'North-South syndrome' or 'Harlequin syndrome' refers to:

Accepted Answer

Differential hypoxia with well-oxygenated lower body but hypoxic upper body when native heart function partially recovers

Answer

When the native heart recovers partially, it ejects desaturated blood (due to pulmonary failure) into the ascending aorta competing with oxygenated ECMO return flow, causing upper body hypoxia.

Question 3

The primary goal of mechanical circulatory support (MCS) in cardiogenic shock is to:

Accepted Answer

Maintain end-organ perfusion while allowing myocardial recovery or bridge to definitive therapy

Answer

MCS in cardiogenic shock aims to maintain adequate end-organ perfusion pressure and flow while the myocardium recovers or the patient is bridged to transplant or durable LVAD.

Question 4

When comparing IABP to Impella in terms of cardiac output support, which statement is most accurate?

Accepted Answer

Impella provides significantly greater active flow augmentation than IABP

Answer

The Impella actively pumps blood (up to 5.5 L/min depending on model), providing significantly greater cardiac output augmentation than the IABP, which augments indirectly through counterpulsation.

Question 5

A 'suction alarm' on the Impella device most commonly indicates:

Accepted Answer

The inlet is positioned too close to the mitral valve or the LV is underfilled

Answer

Suction alarms occur when the device cannot aspirate adequate blood, usually because the inlet is malpositioned near the mitral valve or ventricular volume is insufficient.

RCIS - Registered Cardiovascular Invasive Specialist Practice Test

RCIS - Registered Cardiovascular Invasive Specialist Practice Test

RCIS Intra-Aortic Balloon Pump and Mechanical Circulatory Support 3