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Cardiogenic shock etiology and exit strategy impact survival in patients with Impella 5.5
Journal article   Open access   Peer reviewed

Cardiogenic shock etiology and exit strategy impact survival in patients with Impella 5.5

McKenzie Sicke, Shan Modi, Yeahwa Hong, Michael Bashline, Wyatt Klass, Ed Horn, Barinder S Hansra, Raj Ramanan, Jeffrey Fowler, Nikita Sumzin, …
International journal of artificial organs, v 47(1), pp 8-16
01 Jan 2024
PMID: 38053245
url
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10824236View
Accepted (AM)Open Access (License Unspecified) Open

Abstract

Heart Failure - complications Heart Failure - surgery Heart-Assist Devices - adverse effects Humans Myocardial Infarction - complications Myocardial Infarction - therapy Retrospective Studies Shock, Cardiogenic - complications Shock, Cardiogenic - therapy Treatment Outcome
Despite historical differences in cardiogenic shock (CS) outcomes by etiology, outcomes by CS etiology have yet to be described in patients supported by temporary mechanical circulatory support (MCS) with Impella 5.5. This study aims to identify differences in survival and post-support destination for these patients in acute myocardial infarction (AMI) and acute decompensated heart failure (ADHF) CS at a high-volume, tertiary, transplant center. A retrospective review of patients who received Impella 5.5 at our center from November 2020 to June 2022 was conducted. Sixty-seven patients underwent Impella 5.5 implantation for CS; 23 (34%) for AMI and 44 (66%) for ADHF. AMI patients presented with higher SCAI stage, pre-implant lactate, and rate of prior MCS devices, and fewer days from admission to implantation. Survival was lower for AMI patients at 30 days, 90 days, and discharge. No difference in time to all-cause mortality was found when excluding patients receiving transplant. There was no significant difference in complication rates between groups. ADHF-CS patients with Impella 5.5 support have a significantly higher rate of survival than patients with AMI-CS. ADHF patients were successfully bridged to heart transplant more often than AMI patients, contributing to increased survival.

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Web of Science research areas
Engineering, Biomedical
Transplantation
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