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https://www.readbyqxmd.com/read/28913740/temporary-mechanical-circulatory-support-for-cardiogenic-shock
#1
REVIEW
Jean Touchan, Maya Guglin
Cardiogenic shock is a life-threatening presentation of severe heart failure with high morbidity and mortality. Given the modest increased in cardiac output and neutral/negative survival benefits with today's available inotropes (namely, dobutamine and milrinone), the use of mechanical circulatory support (MCS) has increased dramatically over the past 2 decades. In this review article, we discuss the physiologic concept, clinical evidence of benefit, and current use and indications/potential complications of the four most commonly used devices for MCS: intra-aortic balloon pump, Impella percutaneous ventricular assist device, TandemHeart, and extracorporeal membrane oxygenation (ECMO)...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28862481/utilization-of-the-impella-for-hemodynamic-support-during-percutaneous-intervention-and-cardiogenic-shock-an-insight
#2
Nikhil Nalluri, Nileshkumar Patel, Samer Saouma, Viswajit Reddy Anugu, Dixitha Anugula, Deepak Asti, Varshil Mehta, Varun Kumar, Varunsiri Atti, Sushruth Edla, Rasleen K Grewal, Hafiz M Khan, Ritesh Kanotra, Gregory Maniatis, Ruben Kandov, James C Lafferty, Michael Dyal, Carlos E Alfonso, Mauricio G Cohen
Abstract/Summary Impella is a catheter-based micro-axial flow pump placed across the aortic valve, and it is currently the only percutaneous left ventricular assist device approved for high-risk percutaneous coronary intervention and cardiogenic shock. Even though several studies have repeatedly demonstrated the excellent hemodynamic profile of Impella in high-risk settings, it remains underutilized. Here we aim to provide an up-to-date summary of the literature as well as the practical aspects of its usage during percutaneous interventions...
September 1, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28857849/advanced-percutaneous-mechanical-circulatory-support-devices-for-cardiogenic-shock
#3
P Elliott Miller, Michael A Solomon, Dorothea McAreavey
OBJECTIVES: To review temporary percutaneous mechanical circulatory support devices 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, Impella, and TandemHeart. STUDY SELECTION: Selected publications included randomized controlled trial data and observational studies describing experience with percutaneous mechanical circulatory support in cardiogenic shock...
August 28, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28856523/hemodynamic-support-devices-for-shock-and-high-risk-pci-when-and-which-one
#4
REVIEW
George W Vetrovec
PURPOSE OF REVIEW: This article addresses evolving devices and uses of hemodynamic support in the management of high-risk PCI and AMI with cardiogenic shock. RECENT FINDINGS: Recent publications question the benefit of Intra-aortic Balloon Pump support for AMI Shock. Furthermore, in high-risk PCI, the Impella support system provides better late outcomes than does the intra-aortic balloon pump. We have entered a new era in which larger, higher flow devices that increase cardiac output while unloading the left ventricle provide better outcome...
August 31, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28830286/anticoagulation-of-percutaneous-ventricular-assist-device-using-argatroban-based-purge-solution-a-case-series
#5
Emily C Blum, Carolyn R Martz, Yelena Selektor, Hassan Nemeh, Zachary R Smith, Long To
Impella devices are percutaneously inserted ventricular assist devices which require a continuous purge solution that contains heparin to prevent pump thrombosis and device failure. We describe 2 patients with heparin-induced thrombocytopenia (HIT) supported with an Impella device utilizing an argatroban-based purge solution. Case 1 involved an 83-year-old female with biventricular failure which resulted in right ventricle Impella support. The purge solution was changed to include argatroban due to concern of device clotting in the setting of HIT...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28819956/successful-use-of-impella-cp%C3%A2-in-cardiogenic-shock-after-cardiac-arrest-a-first-in-poland
#6
Paweł Nadziakiewicz, Michał Zembala, Grzegorz Słonka, Wojciech Balak
No abstract text is available yet for this article.
2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28806755/acquired-von-willebrand-syndrome-in-cardiogenic-shock-patients-on-mechanical-circulatory-microaxial-pump-support
#7
Ulrike Flierl, Jörn Tongers, Dominik Berliner, Jan-Thorben Sieweke, Florian Zauner, Christoph Wingert, Christian Riehle, Johann Bauersachs, Andreas Schäfer
Early use of mechanical circulatory support, e.g. veno-arterial extracorporeal membrane oxygenation (ECMO) or left ventricular unloading by microaxial pump in refractory cardiogenic shock is recommended in current guidelines. Development of acquired von Willebrand Syndrome (AVWS) in patients with left ventricular assist devices (LVADs) and ECMO has been reported. There is an increasing number of patients treated with the Impella® CP microaxial pump for left ventricular unloading. However, the prevalence of AVWS in these high risk patients is unknown and needs to be determined...
2017: PloS One
https://www.readbyqxmd.com/read/28772056/right-ventricular-temporal-assist-device-for-cardiac-recompensation
#8
Isabell Yan, Hanno Grahn, Stefan Blankenberg, Dirk Westermann
In this case report, we discuss treatment of a 66-year-old patient with right heart failure due to chronic left heart failure caused by ischemic cardiomyopathy. We decided to manage this patient by implanting a temporary right ventricular assist device (Impella RP®) as a novel therapeutic option for acute on chronic right heart decompensation.
August 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28770279/-treatment-of-an-uncommon-case-of-a-cardiogenic-shock-simultaneous-use-of-a-va-ecmo-and-an-impella-cp%C3%A2
#9
H Haake, K Grün-Himmelmann, U Kania, F Trudzinski, P M Lepper, J Vom Dahl
We report the case of a 48-year old woman where probably the intramuscular administration of glucocorticoids by an orthopedist induced a pheochromocytoma crisis. The development of a cardiogenic shock with a cardiac arrest made the use of a venoarterial extra corporeal membrane oxygenation (VA-ECMO, Cardiohelp®, Maquet, Rastatt) necessary. To treat a pulmonary edema under VA-ECMO an Impella-CP® (Abiomed, Aachen) was implanted. A coronary angiography, endomyocardial biopsies and a computer tomography were performed...
August 2, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28762172/mechanical-circulatory-support-for-decompensated-heart-failure
#10
REVIEW
Tarique Al Musa, Colin Dominic Chue, Hoong Sern Lim
PURPOSE OF REVIEW: Cardiogenic shock from decompensated heart failure is associated with significant morbidity and mortality. Mechanical circulatory support (MCS) improves haemodynamics and reverses organ dysfunction in critically ill patients with cardiogenic shock. This paper summarises the main modalities of mechanical support and their physiological impact, practical considerations, advantages and disadvantages to facilitate a holistic approach in managing a potentially lethal pathology...
July 31, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28741848/pharmacologic-considerations-in-the-management-of-patients-receiving-left-ventricular-percutaneous-mechanical-circulatory-support
#11
J Erin Allender, Brent N Reed, Jenna L Foster, Jeremy D Moretz, Carrie S Oliphant, Douglas L Jennings, Robert J DiDomenico, James C Coons
Percutaneous mechanical circulatory support (MCS) devices, including the intra-aortic balloon pump, Impella, and TandemHeart, are often used for hemodynamic support in the setting of refractory cardiogenic shock. The thrombotic and bleeding complications associated with these devices is well recognized, and the Impella and TandemHeart devices have unique anticoagulation considerations that may influence patient outcomes. Both devices typically require use of a heparinized purge solution in combination with intravenous unfractionated heparin, thereby providing multiple sources of heparin exposure...
July 25, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28736903/a-retrospective-analysis-of-impella-use-in-all-comers-1-year-outcomes
#12
Mohamad Lazkani, Shishir Murarka, Akihiro Kobayashi, Luke Seibolt, Tae Yang, Ashish Pershad
BACKGROUND: There are non-randomized data about the benefits of Impella use in the setting of cardiogenic shock. However, limited data exist to help guide clinicians about whether in the context of the intervention the device should be implanted early or late; how long the device should stay in; and how the mode of explant should be. METHODS: This is a retrospective, single center registry over 5 years comparing in-hospital outcomes and 1 year mortality in an all-comers in patients who had the Impella device placed early versus those who had the device placed late as a bailout...
July 24, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28706127/percutaneous-mechanical-circulatory-support-for-cardiac-disease-temporal-trends-in-use-and-complications-between-2009-and-2015
#13
Bradley W Ternus, Jacob C Jentzer, Abdallah El Sabbagh, Mackram F Eleid, Malcolm R Bell, Joseph G Murphy, Charanjit S Rihal, Gregory W Barsness
BACKGROUND: We present the indications for use, temporal trends, complications, and 1-year clinical outcomes after single-access percutaneous mechanical circulatory support device placement from years 2009-2015 at our institution. METHODS AND RESULTS: Patients with an intraaortic balloon pump (IABP) or Impella device placed in the catheterization suite between January 1, 2009 and December 31, 2015 were included. There were a total of 778 patients in this study. The mean number of devices placed per year was 111...
July 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28704330/proper-positioning-of-an-impella-2-5-and-cp-heart-pump
#14
Bradley B Anderson, Charles D Collard
No abstract text is available yet for this article.
July 13, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28660768/comparison-of-peri-and-post-procedural-complications-in-patients-undergoing-revascularisation-of-coronary-artery-multivessel-disease-by-coronary-artery-bypass-grafting-or-protected-percutaneous-coronary-intervention-with-the-impella-2-5-device
#15
Tobias Becher, Stefan Baumann, Frederik Eder, Simon Perschka, Dirk Loßnitzer, Christian Fastner, Michael Behnes, Christina Doesch, Martin Borggrefe, Ibrahim Akin
BACKGROUND: While coronary artery bypass grafting remains the standard treatment of complex multivessel coronary artery disease, the advent of peripheral ventricular assist devices has enhanced the safety of percutaneous coronary intervention. We therefore evaluated the safety in terms of inhospital outcome comparing protected high-risk percutaneous coronary intervention with the Impella 2.5 device and coronary artery bypass grafting in patients with complex multivessel coronary artery disease...
June 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28659199/-support-of-damaged-heart-with-the-impella-pump
#16
D M Ouweneel, W K Lagrand, B A J M de Mol, J P S Henriques
Temporary mechanical circulatory support is increasingly used, particularly in patients with cardiogenic shock or during high-risk percutaneous coronary interventions. In the last five years there have been numerous developments in this field. Experience has been gained from usage of temporary heart pumps, and new pumps have arrived on the market. Until recently, the intra-aortal balloon pump was the standard treatment for patients with cardiogenic shock; however, results from the latest research into the effectiveness of this pump have rendered it less popular...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28644683/use-of-percutaneous-left-ventricular-assist-device-impella-in-vasodilatory-poison-induced-shock
#17
JoAn R Laes, Chad Olinger, Jon B Cole
No abstract text is available yet for this article.
June 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28591467/the-effect-of-impella-cp-on-cardiopulmonary-physiology-during-venoarterial-extracorporeal-membrane-oxygenation-support
#18
Hoong Sern Lim
Left ventricle (LV) distension is a complication of venoarterial extracorporeal membrane oxygenation (VA-ECMO) support. The effects of Impella on the pulmonary circulatory physiology were studied in a single-center study of six consecutive patients on VA-ECMO support who had LV unloading with Impella. Right ventricular stroke volume, pulmonary hemodynamics, and partial pressure of end-tidal CO2 (PETCO2 ) were measured on echocardiogram, pulmonary artery catheter, and capnography, respectively. The addition of Impella CP increased total blood flow and reduced pulmonary artery wedge pressure...
June 7, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28570258/novel-method-for-exchange-of-impella-circulatory-assist-catheter-the-trojan-horse-technique
#19
Colin T Phillips, Hector Tamez, Thomas M Tu, Robert W Yeh, Duane S Pinto
Patients with an indwelling Impella may require escalation of hemodynamic support or exchange to another circulatory assistance platform. As such, preservation of vascular access is preferable in cases where anticoagulation cannot be discontinued or to facilitate exchange to an alternative catheter or closure device. Challenges exist in avoiding bleeding and loss of wire access in these situations. We describe a single-access "Trojan Horse" technique that minimizes bleeding while maintaining arterial access for rapid exchange of this percutaneous ventricular assist device...
July 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28566938/safety-and-efficacy-of-a-novel-hybrid-closure-technique-in-large-bore-arteriotomies
#20
Michael K Amponsah, Rajiv Tayal, Zain Khakwani, Michael Sinclair, Najam Wasty
The "preclose" technique employing two Perclose (P) devices is well established for large-bore artery (LBA) hemostasis. Occasionally, only one Perclose deploys successfully during the initial preclose because of arterial calcification necessitating the use of the crossover balloon technique to achieve hemostasis at the LBA. We sought to determine if the combined use of one Perclose and either one Angioseal or one Mynx vascular closure device (VCD) is a safe alternative closure technique large-bore arteriotomy closure...
June 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
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