The Impella Device for Acute Mechanical Circulatory Support in Patients in Cardiogenic Shock

Lemaire, Anthony; Anderson, Mark; Lee, Leonard Y.; Scholz, Peter; Prendergast, Thomas; Goodman, Andrew L.; Lozano, Ann Marie; Spotnitz, Alan J.; Batsides, George

doi:10.1016/j.athoracsur.2013.07.053

Cited by 119 publications

(80 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…11 This work adds to other evidence that Impella 5.0 is safe for stabilizing patients. 6,12 End-organ function improves and patients can be extubated and ambulated, making them better candidates for advanced therapies and avoiding ventilator-associated pneumonia and adult respiratory distress syndrome. 13,14 In addition, peripheral access avoids multiple chest entries, decreasing the chance of infections and other complications.…”

Section: Discussionmentioning

confidence: 99%

Temporary Left Ventricular Assist Device Through an Axillary Access is a Promising Approach to Improve Outcomes in Refractory Cardiogenic Shock Patients

et al. 2015

View full text Add to dashboard Cite

Cardiogenic shock (CS) causes significant morbidity and mortality and such patients can deteriorate rapidly. Temporary left ventricular assist devices (LVADs) are a promising approach to manage these patients. The following is a case series in which patients stabilized with a temporary LVAD for CS improvement were analyzed retrospectively. Between June 2011 and January 2014, 15 patients received temporary devices through an axillary approach (mean age: 53 ± 15, 93% male). Mean survival time was 317.8 ± 359.5 days (range: 6–936 days). During support there were no major bleeding events, infectious complications at the axillary access site, upper extremity edema, or emboli. The most of the patients recovered from CS (93%) were mobilized (67%) and were extubated (73%) while on temporary device support. Median times to extubation, intensive care unit discharge, and discontinuation of inotropic medications were: 1.63, 18, and 15 days, respectively. Four patients recovered to no device support and five received a long-term LVAD, all of whom remain alive. Therefore, implantation of a temporary LVAD through an axillary approach is a promising therapy for improving outcomes in patients needing mechanical circulatory support as a bridge to recovery or a definitive LVAD.

show abstract

Section: Discussionmentioning

confidence: 99%

Temporary Left Ventricular Assist Device Through an Axillary Access is a Promising Approach to Improve Outcomes in Refractory Cardiogenic Shock Patients

et al. 2015

View full text Add to dashboard Cite

show abstract

“…26 Several other single center, retrospective studies have shown more favorable outcomes for cardiogenic shock when treated with Impella 5.0. 27 In a multicenter, prospective, feasibility study without a control group, Impella 5.0 was used in 16 patients with postcardiotomy cardiogenic shock with 94% survival at 30 days. 28 …”

Section: Circulatory Support Devicesmentioning

confidence: 99%

“…45 With the exception of vascular injury, complications rates for Impella CP and 5.0 are reportedly comparable with Impella 2.5. 16,17,27 …”

Section: Complicationsmentioning

confidence: 99%

Advanced Percutaneous Mechanical Circulatory Support Devices for Cardiogenic Shock

Miller

Solomon

McAreavey

2017

Critical Care Medicine

View full text Add to dashboard Cite

Objective To review temporary percutaneous mechanical circulatory support devices (pMCS) for the treatment of cardiogenic shock, including current evidence, contraindications, complications, and future directions. Data Sources A MEDLINE search was conducted with MeSH terms: cardiogenic shock, percutaneous mechanical circulatory support, extracorporeal membrane oxygenation (ECMO), Impella, and TandemHeart. Study Selection Selected publications included randomized controlled trial data and observational studies describing experience with pMCS in cardiogenic shock. Data Extraction Studies were chosen based on strength of association with and relevance to cardiogenic shock. Data synthesis Until recently, there were few options if cardiogenic shock was refractory to vasopressors or intra-aortic balloon pump (IABP) counterpulsation. Now, several pMCS devices, including Impella®, TandemHeart™, and ECMO, are more accessible. Compared with IABP, Impella provides greater hemodynamic support, but no reduction in mortality. Similarly, TandemHeart improves hemodynamic variables, but not survival. Comparative studies have been underpowered for mortality because of small sample size. Veno-arterial ECMO offers the advantage of biventricular circulatory support and oxygenation but there are significant vascular complications. Comparative studies with ECMO have not been completed. Despite lack of randomized controlled data, there has been a substantial increase in use of pMCS. Several ongoing prospective studies with larger sample sizes may provide answers, and newer devices may become smaller, easier to insert, and more effective. Conclusions Mortality from cardiogenic shock remains unacceptably high despite early coronary revascularization or other therapies. While evidence is lacking and complications rates are high, improvements and experience with pMCS may offer the prospect of better outcomes.

show abstract

“…The circulatory support provided by the Impella device is only a portion of the benefit as the ability to unload the LV is very significant [5]. The benefit of this Impella system is being more commonly recognized for its survival benefit in patients in acute cardiogenic shock [6]. Taken together, the patient's clinical course demonstrates the utility of the Impella device.…”

Section: Issn: 2165-7920mentioning

confidence: 73%

The Impella Device as a Temporary Bridge for Acute Mechanical Circulatory Support

Lemaire¹,

Lee²,

Ghaly³

et al. 2014

J Clin Case Rep

Self Cite

View full text Add to dashboard Cite

The Impella Device for Acute Mechanical Circulatory Support in Patients in Cardiogenic Shock

Cited by 119 publications

References 13 publications

Temporary Left Ventricular Assist Device Through an Axillary Access is a Promising Approach to Improve Outcomes in Refractory Cardiogenic Shock Patients

Temporary Left Ventricular Assist Device Through an Axillary Access is a Promising Approach to Improve Outcomes in Refractory Cardiogenic Shock Patients

Advanced Percutaneous Mechanical Circulatory Support Devices for Cardiogenic Shock

The Impella Device as a Temporary Bridge for Acute Mechanical Circulatory Support

Contact Info

Product

Resources

About