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Open research questions in Mechanical Circulatory Support Devices

125 unresolved questions extracted from the limitations and future-work sections of 324 Mechanical Circulatory Support Devices papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Recirculation and elevated wall shear stress (WSS) in VV-ECMO. The complexity of the geometric configuration of drainage side holes in DLCs. The need for systematic analysis of the effect of side-hole configuration on recirculation in DLCs.

    Influence of side-hole configuration on recirculation in dual-lumen cannulas for veno-venous extracorporeal membrane oxygenation: a parametric computational fluid dynamics study · 2026 · DOI

  • Further studies could investigate the effects of different side-hole configurations on RF and WSS, - The impact of varying the axial spacing between the infusion outlet and drainage holes on RF and WSS could be explored, - Experimental validation of the computational results could be conducted

    Influence of side-hole configuration on recirculation in dual-lumen cannulas for veno-venous extracorporeal membrane oxygenation: a parametric computational fluid dynamics study · 2026 · DOI

  • investigate the causal relationship between GI bleeding and outcomes in patients with STEMI, - examine the impact of different treatments on GI bleeding and outcomes in patients with STEMI, - study the role of liver disease in the development of GI bleeding and adverse outcomes in patients with STEMI

    Gastrointestinal Bleeding Is Associated with Worse In-Hospital Outcomes in Patients with ST-Segment Elevation Myocardial Infarction: An Analysis of the National Inpatient Sample · 2026 · DOI

  • The incidence of GI bleeding in STEMI patients is low, but mortality increases significantly. The impact of GI bleeding on in-hospital outcomes in STEMI patients is not well understood.

    Gastrointestinal Bleeding Is Associated with Worse In-Hospital Outcomes in Patients with ST-Segment Elevation Myocardial Infarction: An Analysis of the National Inpatient Sample · 2026 · DOI

  • The optimal fluid management strategy for AMI-CS patients remains unclear. There is a lack of understanding of the association between fluid balance trajectories and prognosis in AMI-CS patients. Prior studies have not fully explored the dynamic changes in fluid balance in AMI-CS patients.

    Fluid balance trajectories and prognosis in patients with acute myocardial infarction complicated by cardiogenic shock: a group-based trajectory model approach · 2026 · DOI

  • The incidence of IABP-induced ischemic bowel necrosis varies considerably across studies. There is a need for a thorough understanding of the epidemiological characteristics, pathogenesis, and diagnostic approaches of this condition.

    Case Report: Ischemic bowel necrosis following intra-aortic balloon pump support in a patient with cardiogenic shock · 2026 · DOI

  • There is a lack of data on the use of Impella 5.5 support in high-risk cardiac surgery patients. Prior work has focused on other tMCS platforms, such as IABP and V-A ECMO. There is a need for studies evaluating the use of Impella 5.5 support in this patient population.

    Planned Impella 5.5 Support via Brachiocephalic Artery or Ascending Aorta for Low Ejection Fraction, High-Risk Cardiac Surgery · 2026 · DOI

  • Complex hemodynamic interactions make RHF prediction difficult. The lack of established guidelines hinders timely RV support device implantation. Variability in clinical data and patient responses to LVAD implantation poses a challenge.

    Right heart failure after left ventricular assist device implantation: latest insights and knowledge gaps on mechanism and prediction · 2025 · DOI

  • the heterogeneity of heart failure pathophysiology, - the lack of established guidelines, - the small sample size in some studies (e.g. n = 19 in Brener et al.'s study)

    Right heart failure after left ventricular assist device implantation: latest insights and knowledge gaps on mechanism and prediction · 2025 · DOI

  • Developing effective prevention and treatment strategies - Enhance awareness and response capabilities regarding this serious complication

    Case Report: Ischemic bowel necrosis following intra-aortic balloon pump support in a patient with cardiogenic shock · 2026 · DOI

  • Local practice is to routinely overlap cannula in the FJ configuration; this approach remains poorly described, and its impact on recirculation is not understood.

    Cannula tip separation and configuration as determinants of recirculation in venovenous ECMO · 2026 · DOI

  • Background: Fluid management is crucial in the treatment of patients with acute myocardial infarction complicated by cardiogenic shock (AMI-CS), yet the optimal strategy remains unclear.

    Fluid balance trajectories and prognosis in patients with acute myocardial infarction complicated by cardiogenic shock: a group-based trajectory model approach · 2026 · DOI

  • Whether restoring hemodynamics through HT or LVAD implantation sufficiently resolves neurohormonal activation remains uncertain.

    Memory of the renin-angiotensin system following heart transplantation or implantation of a left ventricular assist device · 2026 · DOI

  • This scoping review aimed to synthesise the functional outcomes assessed using the FSS, describe changes in these outcomes from baseline through discharge and during follow-up, examine the methodologies used to assign and interpret scores, and identify the main limitations and gaps in knowledge.

    Functional assessment in children undergoing extracorporeal membrane oxygenation using the functional status scale: a scoping review · 2026 · DOI

  • Few studies have examined the selection and subsequent choice of vasoactive agents in CS.

    Higher vasoactive usage despite hemodynamic goals is associated with higher mortality in acute myocardial infarction-related cardiogenic shock · 2025 · DOI

  • Intra-aortic balloon pump (IABP) counterpulsation generates pressure changes that are primarily influenced by aortic compliance, an index of arterial elasticity that varies widely among patients with cardiovascular disease.

    Case Report: Intra-aortic balloon pump in a patient with refractory cardiogenic shock complicating severe aortic stenosis—enhanced hemodynamic response with low aortic compliance · 2025 · DOI

  • However, the potential role of aortic compliance in determining IABP efficacy remains poorly understood.

    Case Report: Intra-aortic balloon pump in a patient with refractory cardiogenic shock complicating severe aortic stenosis—enhanced hemodynamic response with low aortic compliance · 2025 · DOI

  • However, a validated clinical prediction model for in-hospital mortality in these patients is still lacking.

    Construction of a predictive model for in-hospital mortality in patients with acute myocardial infarction complicated with cardiogenic shock · 2025 · DOI

  • Background The efficacy and safety of combining extracorporeal membrane oxygenation with continuous renal replacement therapy remain controversial.

    Efficacy and safety of extracorporeal membrane oxygenation combined with continuous renal replacement therapy in the management of pediatric acute respiratory distress syndrome · 2025 · DOI

  • Conclusions and Relevance: This consensus statement on EBPTs in critically ill pediatric patients was developed by an international panel of experts in areas where clinical evidence is still limited.

    Extracorporeal Blood Purification in European Pediatric Intensive Care Units · 2025 · DOI

  • Numerical value for each ranking was translated to a percentage defining the strength of consensus (>90% agreement from panelists signifying strong consensus; <49% signifying no consensus).

    Extracorporeal Blood Purification in European Pediatric Intensive Care Units · 2025 · DOI

  • Interestingly, the impact of patient age and BMI on neurologically favourable outcome was higher in female patients than in male patients, warranting further investigation.

    Gender disparities in patients undergoing extracorporeal cardiopulmonary resuscitation · 2024 · DOI

  • Limited data on acute-on-chronic heart failure (HF) patients exists in the era of axillary mechanical circulatory support with the Impella 5.

    Case Report: Unmasking sustainable left ventricular recovery in chronic heart failure with axillary temporary mechanical circulatory support · 2024 · DOI

  • Similarly, the treatment of patients using combined ECMO and ECLS devices has been, at times, shown to show some benefit; however, these benefits have not been widely studied.

    Case Report: Combined perioperative extracorporeal membrane oxygenation for acute heart failure caused by mitral regurgitation · 2024 · DOI

  • Background and Objectives Despite the common occurrence of neurologic complications during extracorporeal membrane oxygenation (ECMO) support, data on long-term neuropsychiatric, neurocognitive, and functional outcomes are sparse.

    Long-Term Neuropsychiatric, Neurocognitive, and Functional Outcomes of Patients Receiving ECMO · 2024 · DOI

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125 open questions have been extracted from the limitations and future-work passages of 324 Mechanical Circulatory Support Devices papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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