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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
06:10

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Published on: June 12, 2021

Improved survival with ventricular assist device support in cardiogenic shock after myocardial infarction

John W C Entwistle1, Paul B Bolno, Elena Holmes

  • 1Department of Cardiovascular Medicine, Drexel University College of Medicine, Hahnemann University Hospital, Philadelphia, Pennsylvania, USA. john.entwistle@drexel.edu

The Heart Surgery Forum
|January 15, 2004
PubMed

Insights

Left ventricular assist device (LVAD) support offers a 54% survival rate for acute myocardial infarction with cardiogenic shock. Biventricular assist device (BiVAD) support is less effective, primarily stabilizing patients for transplantation with a poor overall prognosis.

Area of Science:

  • Cardiology
  • Medical Devices
  • Mechanical Circulatory Support

Background:

  • Cardiogenic shock post-acute myocardial infarction (AMI) carries a high mortality risk.
  • Medical management often fails in severe AMI-induced cardiogenic shock.
  • Mechanical circulatory support devices are explored for refractory cases.

Purpose of the Study:

  • To evaluate the efficacy of Abiomed devices in treating acute myocardial infarction complicated by cardiogenic shock (AMI-CS).
  • To compare outcomes between left ventricular assist device (LVAD) and biventricular assist device (BiVAD) support in AMI-CS patients.

Main Methods:

  • Retrospective review of 17 patients treated with Abiomed BVS 5000 devices (1994-2002).
  • Patients were categorized based on primary cardiac dysfunction: left ventricular (LV) or biventricular (BiV) failure.
  • Outcomes assessed included device weaning, survival to discharge, and transplantation.

Main Results:

  • Eleven patients with LV dysfunction received LVAD support; 6 (54%) survived to discharge.
  • Six patients with BiV failure received BiVAD support; none were weaned.
  • Two BiVAD patients received transplants, with only one surviving.

Conclusions:

  • LVAD support can achieve a 54% survival rate in AMI-CS patients with predominant left ventricular failure failing medical management.
  • BiVAD support may stabilize patients with biventricular failure for transplantation, but overall prognosis remains poor.
  • Mechanical circulatory support offers a potential survival benefit in select AMI-CS patients.
Abstract

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