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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

Safety and efficacy of left ventricular assist device support in postmyocardial infarction cardiogenic shock

Bradley G Leshnower1, Thomas G Gleason, Mary Lou O'Hara

  • 1Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.

The Annals of Thoracic Surgery
|March 28, 2006
PubMed

Insights

Left ventricular assist device (LVAD) support with apical cannulation is a safe and effective treatment for patients experiencing cardiogenic shock after a heart attack. This therapy improves survival rates and should be considered for appropriate patients.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Medical Devices

Background:

  • Cardiogenic shock secondary to acute myocardial infarction (CS-AMI) is a major cause of mortality in acute coronary syndromes.
  • Limited data exists on left ventricular assist device (LVAD) use in CS-AMI patients.
  • Apical cannulation for LVAD implantation in anterior myocardial infarction presents surgical challenges.

Purpose of the Study:

  • To evaluate the safety and efficacy of LVAD support with apical cannulation in patients with CS-AMI.
  • To compare outcomes of CS-AMI patients receiving LVADs with those with chronic ischemic cardiomyopathy.

Main Methods:

  • Retrospective review of a ventricular assist device (VAD) database.
  • Analysis of 49 CS-AMI patients (Group I) and 61 chronic ischemic cardiomyopathy patients (Group II) who received LVAD support from April 1995 to February 2005.

Main Results:

  • LVAD support successfully bridged 74% of CS-AMI patients and 61% of chronic ischemic cardiomyopathy patients to heart transplantation.
  • Survival to hospital discharge after transplantation was 87% for CS-AMI patients and 97% for the comparison group.
  • Overall in-hospital mortality rates were 33% for CS-AMI patients and 41% for the comparison group.

Conclusions:

  • LVAD support, including apical cannulation, is a safe and effective therapy for CS-AMI.
  • This treatment should be integrated into the standard care for eligible CS-AMI patients.
  • LVADs offer a viable option for managing this life-threatening condition.
Abstract

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