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Updated: Aug 6, 2026
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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Axial Flow Percutaneous Ventricular Assist Devices: Physiology, Procedural Considerations, and Clinical
Ovidio De Filippo1,2, Ilaria Pagliassotto3, Valentina Braia3
1Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital, Turin, Italy.
Structural Heart : the Journal of the Heart Team
|July 20, 2026
Summary
Percutaneous microaxial flow pumps like Impella offer advantages in cardiac dysfunction. While potentially improving survival in cardiogenic shock, risks like bleeding and thrombosis require careful patient selection and further research.
Area of Science:
- Cardiology
- Mechanical Circulatory Support
Background:
- Percutaneous microaxial flow pumps are crucial for temporary mechanical circulatory support in advanced cardiac dysfunction.
- Impella devices provide physiological advantages by unloading the ventricle, reducing pressure, and supporting perfusion.
Purpose of the Study:
- To review the mechanisms, applications, and evidence for axial-flow percutaneous ventricular assist devices.
- To summarize procedural considerations, monitoring, and complication management.
Main Methods:
- This is a state-of-the-art review.
- It synthesizes current evidence on Impella devices in various cardiac conditions.
Main Results:
- Early Impella use may improve survival in infarct-related cardiogenic shock but increases risks of bleeding and thrombosis.
- In high-risk PCI, Impella may improve procedural stability but survival benefits are unproven.
- Emerging applications include RV support, biventricular support, and use with ECMO.
Conclusions:
- Optimal use, patient selection, and weaning protocols for Impella devices require further investigation.
- Randomized trials and technological advancements are needed to maximize benefits and minimize complications.
