Mechanical Circulatory Support Devices for Cardiogenic Shock: State of the Art

Hajjar, Ludhmila Abrahão; Teboul, Jean–Louis

doi:10.1186/s13054-019-2368-y

Cited by 68 publications

(85 citation statements)

References 50 publications

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“…Short-term MCS options include intra-aortic balloon pump, Impella, TandemHeart (TandemLife) and extracorporeal membrane oxygenation ( Table 2 ). [ 35 – 37 ]…”

Section: Procedural Considerations For Hybrid Ablationmentioning

confidence: 99%

Hybrid Catheter-Based and Surgical Techniques for Ablation of Ventricular Arrhythmias

Khalil

Siontis

Bagameri

et al. 2020

Arrhythmia &Amp; Electrophysiology Review

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Catheter ablation is a rapidly expanding and evolving field. The advent of interventional techniques and advances in technology have allowed catheter ablation to supplant antiarrhythmic surgery for ventricular arrhythmia treatment. However, issues related to access and energy delivery limit the use of catheter ablation in some cases. Hybrid catheter-based and surgical techniques represent a novel approach to overcome these limitations. The hybrid technique combines the strengths and minimises the limitations of either catheter or surgical ablation alone. There is a growing body of evidence in the literature supporting the safety and efficacy of the hybrid surgical technique. This review aims to provide an overview of hybrid surgical-catheter ablation for ventricular arrhythmia.

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“…Short-term MCS options include intra-aortic balloon pump, Impella, TandemHeart (TandemLife) and extracorporeal membrane oxygenation ( Table 2 ). [ 35 – 37 ]…”

Section: Procedural Considerations For Hybrid Ablationmentioning

confidence: 99%

Hybrid Catheter-Based and Surgical Techniques for Ablation of Ventricular Arrhythmias

Khalil

Siontis

Bagameri

et al. 2020

Arrhythmia &Amp; Electrophysiology Review

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“…The goal is bridge-to-decision, whether it is stabilization for surgical closure of PIVSD in patients with preserved myocardial mass or palliation or a more durable MCS such as implantable ventricular assist device (VAD)s or heart transplantation in those with extensive myocardial dysfunction. 18 However, because of the high costs involved, such facilities are available in a small number of cardiac centers in India. Late initiation of tMCS may also allow MODS to develop.…”

Section: Incidence and Types Of Csmentioning

confidence: 99%

Outcome Analysis After Surgical Management of Ventricular Septal Defect Complicating Acute Myocardial Infarction

Dasbaksi¹,

Haldar²,

Hossain³

et al. 2019

IJCMR

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Introduction: Surgical approaches to closure of post myocardial infarction ventricular septal defect (PIVSD) are associated with high morbidity and mortality. Timing of intervention for its closure remains controversial. Several studies advocate early operative intervention, after diagnosis of PIVSD but these are associated with high mortality. However, the strategy of delayed closure around 14 to 20 days or higher has been advocated in certain subsets of patients who can be stabilized from cardiogenic shock (CS) with pharmacological means with or without temporary mechanical circulatory support (tMCS). This helps to allow tissue fibrosis around PIVSD which increases the chance of operative success. Results of 5 such patients in whom surgery was moderately delayed, and 2 in whom early operation were performed are reported in this paper. Material and methods: Between May 2012 to April 2016, 7 consecutive patients of PIVSD had operative closure under cardio pulmonary bypass in our hospital. 5 patients had diuretic and inotrope responsive CS and had delayed closure of PIVSD within 12 to 20 days, while 2 with severe CS, who were supported preoperatively with tMCS like intra aortic balloon pump (IABP), had early closure within 72 hours. Patient data of these seven subjects were retrospectively collected, and the current status of the survivors was ascertained by out patient follow up. Results: 4 of 5 patients from delayed surgery group with small PIVSD survived while 1 patient had early mortality due to severe right ventricular dysfunction post operatively resulting in LCOS. 1 patient out of the 2 early surgery group with a large PIVSD survived while the other patient with a small PIVSD and an extensive MI had early post operative mortality. 1 had from late surgery group had delayed mortality after 3 years. 4 patients are living at present. Conclusion: We advocate delayed elective repair of PIVSD, in patients with CS who responded to aggressive conservative management maintaining hemodynamic stability, to allow inflammatory state to subside. In those patients with severe CS, additional rescue therapy with temporary mechanical circulatory support is needed to prevent further deterioration of systemic perfusion. If the severe CS is due to high left to right shunt rather than infarct size, prognosis after repair of PIVSD is better than in patients with CS due to extensive myocardial damage.

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“…In cardiogenic shock, ventricular abnormalities mainly manifest as irreversible contraction and diastolic dysfunction, leading to reduced cardiac output, increased ventricular diastolic pressure, and decreased coronary perfusion pressure. Left ventricular (LV) dysfunction and ischemia are the most common complications, elevating left atrial pressure, leading to pulmonary edema, hypoxia, pulmonary blood vessel convulsion, and worsening ischemia [ 4 , 5 ]. Fluids, vasopressors, and inotropes are usually used to assure cardiac output and oxygen delivery.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of VA-ECMO with and without Left Centricular (LV) Decompression Using Intra-Aortic Balloon Pumping (IABP) versus Other LV Decompression Techniques: A Systematic Review and Meta-Analysis

et al. 2020

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Background Left ventricular decompression is the primary method for solving VA-ECMO-induced LV afterload increase, but the effect of specific methods on patient outcomes and complications is unknown. Material/Methods We searched for all published reports conducted in patients undergoing ECMO combined with LVD. Statistical analyses were performed using Stata 12.0. Results The results showed that the risk of death with ECMO combined with LVD was 29% lower than that with ECMO alone (OR=0.71, 95% CI: 0.56–0.89, I 2 =59.5%, P < 0.001 ). Although the risk of death with ECMO combined other LV decompression techniques was higher than that with ECMO combined with IABP, the difference was not statistically significant (OR=1.27, 95% CI: 0.86–1.87, I 2 =44.0%, P = 0.057 ). In addition, the ORs values of hemorrhage, stroke/acute episodes, lower-limb ischemia, and hemolysis for ECMO combined with LVD were 0.69 (0.66–0.71), 0.82 (0.78–0.89), 0.71 (0.30–1.66), and 0.48 (0.16–1.39), respectively. The risk of complications, such as stroke/TIA, limb ischemia, and hemolysis, of ECMO combined with IABP was lower than that of ECMO combined other LV decompression techniques, and the risk of bleeding was higher for ECMO combined with IABP. Conclusions ECMO combined with LVD is more beneficial than using ECMO alone and helps to lower patient mortality.

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Mechanical Circulatory Support Devices for Cardiogenic Shock: State of the Art

Cited by 68 publications

References 50 publications

Hybrid Catheter-Based and Surgical Techniques for Ablation of Ventricular Arrhythmias

Hybrid Catheter-Based and Surgical Techniques for Ablation of Ventricular Arrhythmias

Outcome Analysis After Surgical Management of Ventricular Septal Defect Complicating Acute Myocardial Infarction

Outcomes of VA-ECMO with and without Left Centricular (LV) Decompression Using Intra-Aortic Balloon Pumping (IABP) versus Other LV Decompression Techniques: A Systematic Review and Meta-Analysis

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