Which are the minimally invasive ventricular assist devices?

• A. Intra Aortic Balloon Pump (IABP) and Impella Cardiac Assist Device
• B. Left Ventricular Assist Device (LVAD) and Right Ventricular Assist Device (RVAD)
• C. ECMO and LVAD
• D. Impella and ECMO

Answer: (A)

The idea being tested is what counts as a minimally invasive approach to providing ventricular support. Minimally invasive ventricular support devices are those that can be placed without open surgery and provide either direct pumping from the ventricle or supplemental circulatory support.

Impella is a true percutaneous ventricular assist device: a small pump inserted through a femoral artery and positioned across the aortic valve to move blood from the left ventricle into the aorta. That direct, catheter-based pump provides active forward flow without requiring open chest surgery, which is why it’s considered a minimally invasive VAD.

Intra-aortic balloon pump, while not a pump in the same sense as an Impella, is also catheter-based and placed via the femoral (or other access) route to augment circulation. It works by counterpulsation in the aorta—inflating during diastole to improve coronary perfusion and deflating just before systole to reduce afterload—thereby supporting the heart’s pumping indirectly. This makes it a minimally invasive form of mechanical circulatory support, suitable for short- term stabilization.

By contrast, a left or right ventricular assist device typically refers to larger devices implanted surgically, often requiring sternotomy or thoracotomy for long-term support. ECMO provides extracorporeal oxygenation and circulation support via external circuits and cannulas, which is a different modality and not classified as a ventricular assist device. Hence, the combination of a percutaneous Impella and an intra-aortic balloon pump best fits the description of minimally invasive ventricular support.