Outcome Evaluation of the Bridge to Bridge Concept in Patients With Cardiogenic Shock

Hoefer, Daniel; Ruttmann, Elfriede; Poelzl, Gerhard; Kilo, Juliane; Hoermann, Christoph; Margreiter, Raimund; Laufer, Guenther; Antretter, Herwig

doi:10.1016/j.athoracsur.2006.02.056

Cited by 124 publications

(78 citation statements)

References 18 publications

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“…69 In the largest reported LVAD series to date, 74% of 49 patients survived to transplantation, and 87% of transplanted patients survived to hospital discharge after receiving a variety of surgical LVADs. 70 The risk of bleeding is no higher after MI than in chronic heart failure despite placement of a cannula in the LV apex, which may be necrotic.…”

Section: Total Circulatory Support: LV Assist Devices and Extracorpormentioning

confidence: 99%

Cardiogenic Shock

2008

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ardiogenic shock (CS) occurs in Ϸ5% to 8% of patients hospitalized with ST-elevation myocardial infarction (STEMI). Recent research has suggested that the peripheral vasculature and neurohormonal and cytokine systems play a role in the pathogenesis and persistence of CS. Early revascularization for CS improves survival substantially. New mechanical approaches to treatment are available, and clinical trials are feasible even in this high-risk population. Most importantly, hospital survivors have an excellent chance for long-term survival with good quality of life. This review will outline the causes, pathophysiology, and treatment of CS with a focus on CS complicating myocardial infarction (MI.) The case will be made for viewing CS as a serious disorder with a high early death rate, but one that is treatable and that, if approached aggressively, can result in full recovery. The diagnosis is usually made with the help of pulmonary artery (PA) catheterization; however, Doppler echocardiography may also be used to confirm elevation of LV filling pressures. 1 Hypoperfusion may be manifest clinically by cool extremities, decreased urine output, and/or alteration in mental status. Hemodynamic abnormalities form a spectrum that ranges from mild hypoperfusion to profound shock, and the short-term outcome is directly related to the severity of hemodynamic derangement. MI with LV failure remains the most common cause of CS. It is critical to exclude complicating factors that may cause shock in MI patients. Chief among these are the mechanical complications: ventricular septal rupture, contained free wall rupture, and papillary muscle rupture. Mechanical complications must be strongly suspected in patients with CS complicating nonanterior MI, particularly a first MI. Echocardiography is the technique of choice to rule out these entities and should be performed early unless the diagnosis is extensive anterior MI and the patient is undergoing prompt percutaneous coronary intervention (PCI). In addition, the detection of valvular disease before angiography may alter the revascularization approach. Diagnosis and CausesHemorrhage, infection, and/or bowel ischemia may contribute to shock in the setting of MI. As with mechanical complications, a high index of suspicion is required to make these diagnoses in MI patients, and survival may depend on timely recognition and treatment.Any cause of acute, severe LV or RV dysfunction may lead to CS. Acute myopericarditis, tako-tsubo cardiomyopathy, and hypertrophic cardiomyopathy may all present with ST elevation, release of cardiac markers, and shock in the absence of significant coronary artery disease. Stress-induced cardiomyopathy, also known as apical ballooning or takotsubo cardiomyopathy, is a syndrome of acute LV dysfunction after emotional or respiratory distress that leads to CS in 4.2% of cases. 2 Acute valvular regurgitation, typically caused by endocarditis or chordal rupture due to trauma or degenerative disease, may also cause CS. Aortic dissection may lead to CS via acute,...

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Section: Total Circulatory Support: LV Assist Devices and Extracorpormentioning

confidence: 99%

Cardiogenic Shock

2008

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“…On the other hand, the patients who were weaned or bridged to transplantation had a higher overall survival (40% and 45%, respectively). In another study, Hoefer et al [18] reported excellent results with ECMO support in patients with cardiogenic shock.…”

Section: Discussionmentioning

confidence: 96%

The Levitronix CentriMag ventricular assist device as a bridge to decision in patients with end-stage heart failure: Our single-center experience

Rabuş¹

2017

Turk Gogus Kalp Dama

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Rabuş MB, Salihi S, Hasanov S, Fedakar A, Çevirme D, Balkanay M. The Levitronix CentriMag ventricular assist device as a bridge to decision in patients with end-stage heart failure: Our single-center experience. Turk Gogus Kalp Dama 2017;25(4):543-9. ABSTRACTBackground: In this study, we report early outcomes of Levitronix CentriMag device implantation for bridge to decision for patients with end-stage heart failure in a single center.

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“…All required inotropic support and use of ECLS was also significantly higher than in group 2. Patients without previous cardiomyopathy, who develop severe BV contractile failure, often need early hemodynamic support, including ECLS [19].…”

Section: Discussionmentioning

confidence: 99%