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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

Removal of Impella® 2.5 while maintaining vascular access: a solution to a vascular quandary

Michael S Kim1, Stacey Clegg, John C Messenger

  • 1Department of Medicine, Division of Cardiology, University of Colorado, Denver, Aurora, Colorado.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|August 29, 2013
PubMed

Insights

Cardiogenic shock patients often face high mortality. This case report details a method to maintain vascular access when switching between mechanical support devices, improving patient outcomes.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Mechanical Circulatory Support

Background:

  • Cardiogenic shock (CS) following acute myocardial infarction (AMI) carries a high mortality rate.
  • Hemodynamic support devices are recommended for CS in ST-elevation myocardial infarction (STEMI).
  • Maintaining vascular access during device exchange, especially with anticoagulation, presents a significant challenge.

Observation:

  • This report describes a novel approach to manage vascular access during device exchange.
  • The technique facilitated the transition from an Impella® 2.5 device to a TandemHeart system.
  • Successful maintenance of access was achieved in a patient with refractory CS.

Findings:

  • A specific strategy was employed to preserve percutaneous vascular access post-Impella® removal.
  • This allowed for the safe and effective implantation of the TandemHeart system.
  • The described method addresses a critical complication in managing CS patients requiring device escalation.

Implications:

  • This technique offers a potential solution for maintaining hemodynamic support in complex CS cases.
  • It may improve the management of patients requiring sequential mechanical circulatory support.
  • Further investigation into this vascular access strategy could enhance CS patient care pathways.

Keywords:
TandemHeartcardiogenic shock

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