PulseCath iVAC 2L,online test (RF65-00)

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1. Which one of these answers can not be said about iVAC 2L

Assist Device
Pulsatile
Right ventricle
Percutaneous
Mechanical

2. iVAC 2L is, except:

LV-to-RA pulsatile -flow based Left Ventricular Assist Device (LVAD)
Trans-aortic flow LVAD based on counterpulsation
Right ventricular assist device
LA-to-aorta pulsatile flow LVAD
Axial-flow LVAD with a membrane Oxygenator embedded

3. What is not a clinical effect with iVAC 2L listed below

Increase cardiac output
Increase diastolic pressure
Decrease myocardial oxygen consumption
Increase end organ perfusion
Increase afterload

4. What is the hemolysis level of iVAC 2L (fHb)?

10 mg/dl
25 mg/dl
50 mg/dl
75 mg/dl
100 mg/dl

5. iVAC 2L catheter is:

15 Fr
16 Fr
17 Fr
18 Fr
19 Fr

6. What is the maximum period of use allowed for iVAC 2L?

6 hours
12 hours
18 hours
24 hours
36 hours

7. What is the size of the access sheath which is used to introduce the iVAC 2L?

15 Fr
16 Fr
17 Fr
18 Fr
19 Fr

8. Which components are not included in iVAC 2L box?

Extention tube
Clamp
IABP
Teflon introducer
Access sheath 18 Fr

9. Which contraindication is not applicable for the iVAC 2L?

Thrombus in LV
Presence of mechanical aortic valve
Femoral artery diameter smaller than 6 mm
Aortic valve insufficiency more than grade 2

10. Contra Indications of the iVAC 2L are: (select all that apply)

Aortic disease: ascending aortic aneurism, severe aortic wall calcifications
Aortic valve disease: aortic valve stenosis, aortic valve insufficiency
Aortic valve prothesis
Femoral artery stenosis
Aneurism of the aorta
Thrombus in left ventricle
Thrombus in left ventricle
No residual function of left ventricle
"Right ventricular failure"

11. Indication of iVAC 2L is:

The iVAC 2L is intended for use in patients with impaired left ventricular function which require left ventricular mechanical support for up to 24 hours.
The iVAC 2L is intended for use in patients with impaired left ventricular function which require left ventricular mechanical support for up to 48 hours.
The iVAC 2L is intended for use in patients with impaired right ventricular function which require right ventricular mechanical support for up to 24 hours.
The iVAC 2L is intended for use in patients with impaired left ventricular function which require left ventricular mechanical support for up to 96 hours.

12. Contents of the iVAC 2L box is: (select all that apply)

LV17 catheter with insertion set
Membrane pump
Catheter protector
Extra PTFE Catheter inner tube
Introducer Sheath

13. Necessary equipment and disposables for a procedure with iVAC 2L: (select all that apply)

IABP driver
Introducer Sheath, wth inside diameter 18 Fr minimum
Guide wire: 0.035"or 0.038", length 260 cm (Super Stiff) and corresponding needle
Heparinized saline (2500 IU heparin in 500 ml saline
"IAB catheter extender"
When using an Arrow ACAT1 or AutoCat2Wave IABP Driver: Arrow 50 CC IAB connector. This connector replaces the male lure lock of the "IAB catheter extender"
Closure device for large bore
50cc syringe
16mm metal clamp
iVAC 2L driver

14. iVAC 2L:

Up to 2 L/min circulatory support in severe left ventricular failure and during high-risk revascularization procedures.
Up to 1,5 L/min circulatory support in severe left ventricular failure and during high-risk revascularization procedures.
Up to 2,5 L/min circulatory support in severe left ventricular failure and during high-risk revascularization procedures.

15. Complications. Invasive procedures should not be attempted by physicians unfamiliar with the possible complications. Complications may occur at any time during the procedure. Possible complications include,but are not limited to the following: (select all that apply)

Ischemia of the leg due to obstruction of the femoral artery.
Vascular damage to the femoral artery or aorta.
Perforation.
Thrombosis at the insertion site.
Thrombosis when the iVAC 2L is stopped for a longer period of time.
CVA
Thrombus formation.
Injury of the aortic valve.
Potential induction of mitral valve incompetence.
Infection.
Damage of blood cells.

16. Technology of iVAC 2L: Flexible thin-walled catheter containing a combined two way valve and connected to a single port membrane pump

Yes, this is correct.
No, this is not correct.

17. What is the length of the catheter?

100 cm
120 cm
260 cm

18. What is the content of the membrane pump?

50 cc
60 cc
40 cc

19. What is the distance from the bi-directional valve to the tip of the iVAC 2L catheter?

100 mm
110 mm
73 mm
83 mm

20. An advantage of the iVAC 2L is that the system is compatible with a standard IABP console and does not require dedicated hardware.

Yes, that is correct.
No, that is not correct.

21. Mechanism of action of the iVAC2L. Please select all that apply.

When the heart is in the systolic phase, blood is aspirated from the ventricle trough the tip of the catheter and transported via the lumen into the membrane pump.
During the diastolic phase, the membrane pump (with the IABP console as a driver) directs the blood back through the catheter to the ascending aorta by opening the 2-way valve.
The pulsatile synchronization between closing of the aortic valve and the opening of the catheter valve ensures that the aortic valve function is not impaired, but supported.

22. iVAC 2L is based on pulsatile flow and Impella CP is based on continuous flow.

Yes, that is correct
Not, that is not correct.

23. Operating the IABP driver. The shape of the “Balloon Pressure Waveform” gives an indication of correct functioning. Is this round shape of the pressure peaks correct?

Yes, the shape is correct.
No, this shape is not correct.

24. Cardiac performance. Select all applicable.

Decreased diastolic filling time = decreased stroke volume
Decreased diastolic pressure = decreased myocardial oxygen supply
Increased heart rate = increased demand for myocardial oxygen

25. What are alternative procedures? Select all that apply.

The Impella® heart pump pulls blood from the left ventricle through an inlet area near the tip and expels blood from the catheter into the ascending aorta offering hemodynamic support to the heart and organs including the brain and kidneys.
An intra-aortic balloon pump, or IABP, is a long, skinny balloon that controls the flow of blood through the aorta. The balloon deflates during systolic and inflates during diastolic phases. The inflation increases diastolic pressure (diastolic augmentation) and deflation reduces afterload AP.
ECMO – is an extracorporeal technique of providing prolonged cardiac and respiratory support to persons whose heart and lungs are unable to provide an adequate amount of gas exchange or perfusion to sustain life.

26. PULsecath mechanical Support Evalution (PULSE) trial from Prof.Dr. Nicolas van Mieghem, Erasmus Medical Center is: (please select all that apply)

Multi center (2 centers)
The objective of this study is to determine ventricular loading conditions during and after PulseCath® iVAC2L support, and assess its impact on specific load dependent humoral factors and cardiac enzymes. These specific patterns are so far unknown.
Primary outcome measures: Change in Pressure-volume Ares (PVA)
The PV loops will demonstrate how iVAC 2L (pulsatile flow) affects the cardiac workload as well as its energetic demands.

27. Escalation of Medical Circulatory Support devices in cardiogenic shock. At what stage is iVAC 2L indicated?

1
2
3
4

28a. Please select the devices: Impella CP

Picture 1
Picture 2
Picture 3

28b. Please select the devices: Heartmate PHP

Picture 1
Picture 2
Picture 3

28c. Please select the devices: iVAC 2L

Picture 1
Picture 2
Picture 3

29. Pressure Waveform with support

Yes, this is correct.
No, this is not correct.

30. Pressure Waveform without support

Yes, this is correct.
No, this is not correct.

31. What should be the position of the iVAC 2L tip inside the left ventricle?

1-2 cm
2-3 cm
3-4 cm

32. Positioning of the iVAC 2L. What is correct?

The tip of the catheter is located in the left ventricle and the catheters bi-directional valve in the aorta.
The tip of the catheter and the catheters bi-directional valve are located in the left ventricle.

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PulseCath iVAC 2L,online test (RF65-00)