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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Retrospective analysis of circulatory support with the Impella CP® device in patients with therapy refractory

K Lackermair1, S Sattler2, B C Huber1

  • 1Department of Cardiology, Munich University Clinic, Ludwig-Maximilians University, Munich, Germany.

International Journal of Cardiology
|June 22, 2016
PubMed

Insights

The Impella CP® device offers feasible and safe left ventricular support in severe cardiogenic shock (CS). Survival rates in CS patients treated with Impella CP® appear improved compared to predicted mortality.

Area of Science:

  • Cardiology
  • Mechanical Circulatory Support

Background:

  • Cardiogenic shock (CS) requires rapid left ventricular support.
  • The Impella CP® device offers circulatory support up to 4.0 L/min.
  • Systematic analysis of Impella CP® use in CS is lacking.

Purpose of the Study:

  • To analyze the feasibility and safety of Impella CP® in severe, refractory CS.
  • To evaluate 30-day survival rates in patients treated with Impella CP®.
  • To compare outcomes based on CS aetiology and use of extracorporeal life support (ECLS).

Main Methods:

  • Retrospective analysis of 28 consecutive CS patients treated with Impella CP®.
  • Mortality estimation using the SAPS II Score.
  • Assessment of 30-day survival, CS aetiologies, and impact of additional ECLS.

Main Results:

  • Acute coronary syndrome (ACS) was the most common aetiology (15 patients).
  • 30-day survival was 36% (18 deaths), compared to an estimated mortality of 87.1% (SAPS II Score 73±14).
  • ACS-CS patients showed a trend towards better survival; ECLS did not significantly alter survival. Vascular complications occurred in 3 patients; haemolysis was common.

Conclusions:

  • Impella CP® application is feasible and safe in severely ill CS patients.
  • Observed 30-day survival suggests an improvement compared to predicted mortality.
  • Further investigation into Impella CP® efficacy in specific CS aetiologies is warranted.
Abstract

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