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Updated: Oct 18, 2025
Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Outcome of Impella 2.5 use in patients undergoing Percutaneous Coronary Intervention in Henan, China: a case series
Rafiq Ahmed Bhat1, Syed Manzoor Ali2, Akanksha Rathi3
1Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, People's Republic of China.
Insights
Percutaneous hemodynamic support with Impella 2.5 shows promise for high-risk patients undergoing Percutaneous Coronary Intervention (PCI). This approach may improve outcomes in acute myocardial infarction with cardiogenic shock, though further research is needed.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Acute myocardial infarction with cardiogenic shock (AMI-CS) has high mortality (33-55%) and limits Percutaneous Coronary Intervention (PCI) options.
- High-risk PCI patients often face poor prognoses.
Purpose of the Study:
- To evaluate the efficacy of the Impella 2.5 hemodynamic support device in high-risk PCI patients.
- To assess if Impella 2.5 improves outcomes in patients with acute myocardial infarction and heart failure.
Main Methods:
- A case series of six patients with AMI, low ejection fraction, and acute heart failure who underwent Impella 2.5 (Left Ventricular Assist Device) implantation.
- PCI procedures were performed with Impella 2.5 support.
Main Results:
- All PCI procedures were completed safely under Impella support.
- Hemodynamic parameters improved in most patients within 30 days and 12 months post-procedure.
- Two patients experienced mortality: one from cardiogenic shock post-PCI, another from heart failure and pneumonia at 12 months.
Conclusions:
- Percutaneous hemodynamic support using Impella 2.5 is feasible and potentially beneficial for high-risk PCI.
- Larger studies are required to confirm these findings and establish the role of Impella in AMI-CS.
Background:
Acute myocardial infarction (AMI) complicated by cardiogenic shock (AMI-CS) or heart failure is associated with an unacceptably high in-hospital mortality of 33%-55% and a lost chance to accept PCI (Percutaneous Coronary Intervention).
Aim:
The aim of the study was to find out whether percutaneous hemodynamic support device Impella 2.5 improves prognosis of high-risk PCI patients or not.
Methods:
This study was a case series involving six patients who underwent a Left Ventricular Assist Device (LVAD, Impella 2.5, Abiomed, Danvers, MA) implantation after suffering from AMI with a very low ejection fraction and acute heart failure. The clinical experience and outcomes of the patients are hereby discussed.
Results:
All PCI procedures were safely completed under LVAD support. The hemodynamic parameters of all patients improved clinically over the next 30 days and following 12 months after Impella insertion except in two patients, of which one patient (Case number 6) died 4 days post-Impella protected PCI procedure due to acute left ventricle heart failure with cardiogenic shock and pulmonary oedema; and another one died at 12 months after Impella protected PCI procedure (Case number 4) due to decompensated heart failure and infected pneumonia.
Conclusion:
Percutaneous hemodynamic support is favorable and feasible during high risk Percutaneous Coronary Intervention (PCI). A bigger study is needed to substantiate the claims of the current study.
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