Background: Acute right ventricular failure is a critical complication after left ventricular assist device (LVAD) implantation, often managed with a temporary paracorporeal right ventricular assist device (RVAD). This study examined three extracorporeal life support (ECLS) systems regarding mortality, bleeding complications, and intensive care unit (ICU) stay duration. Methods: This monocentric, retrospective case–control study included all patients receiving LVAD with paracorporeal RVAD between 2009 and 2020. Three patient groups were formed: Centrimag^TM (A), Cardiohelp^TM (B), and Deltastream^TM (C). Results: A total of 245 patients were included. Preoperative parameters were similar between the Centrimag^TM and Deltastream^TM groups, but Cardiohelp^TM patients had worse Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) Scores (A: 1.7 ± 0.8, B: 1.36 ± 0.5, C: 1.9 ± 0.9; p < 0.05). In-hospital death rates were A: 61 (41.8%), B: 15 (32.6%), C: 29 (54.7%); p < 0.05, and reoperation due to bleeding rates were A: 32 (21.9%), B: 8 (17.4%), C: 25 (47.2%); p < 0.05, with the Deltastream^TM group showing the highest rates. This group also had increased thrombocyte consumption and prolonged ICU stays. Conclusions: Temporary RVADs lead to bleeding complications, affecting patient outcomes. The Deltastream^TM group had significantly higher bleeding complications, likely due to high pump revolution rates and thrombocyte decline. Due to the study’s retrospective nature and complex patient profiles, these interesting findings should be validated in future studies.

Background/Objectives: This study aimed to assess the effectiveness and clinical relevance of intraprocedural invasive measurements—specifically intraprocedural mean pressure gradients (IC MPGs) and diastolic delta (DD)—in comparison with echocardiography for evaluating transcatheter heart valve (THV) performance across different prosthesis types. Particular attention was paid to comparing outcomes between balloon-expandable (BE) and self-expandable (SE) valves, with further stratification by aortic annulus size. Methods: A retrospective analysis was performed on 926 patients who underwent transcatheter aortic valve replacements (TAVRs) between 2012 and 2021. Patients were categorized into BE (n = 301) and SE (n = 625) valve groups. Intraprocedural MPG was measured immediately before and after valve deployment. Postprocedural echocardiographic MPG (EC MPG) and the degree of aortic regurgitation were assessed within five days after implantation. Aortic annuli were classified as small (≤23 mm) or large (≥24 mm). Results: After implantation, EC MPG was consistently higher than IC MPG, with only a weak correlation observed between the two modalities. SE valves were generally associated with lower EC MPG than BE valves. DD was higher in the BE group; however, no significant correlation was found between DD and echocardiographically assessed aortic regurgitation. Conclusions: Intraprocedural invasive measurements offer a reliable and immediate assessment of prosthesis function during TAVR but tend to underestimate gradients compared to echocardiography. Newer SE valves show performance comparable to BE valves, particularly in small annuli, supporting their use in challenging anatomies. DD appears to lack a diagnostic value for postprocedural aortic regurgitation.