Percutaneous Left-Ventricular Support With the Impella-2.5–Assist Device in Acute Cardiogenic Shock

• DOI: 10.1161/circheartfailure.112.967224
• Publication Date: 2012-12-05T16:00:29Z
• Authors: Alexander Lauten; Annemarie E. Engs...; Christian Jung; Klaus Empen; Paul Erne; Stéphane Cook; Stephan Windecker; Martin W. Bergmann; Roland Klingenberg; Thomas F. Lüscher; Michael Haude; Dierk Rulands; Christian Butter; Bengt Ullman; Laila Hellgren; Maria Grazia Modena; Giovanni Pedrazzini; Jose P.S. Henriques; Hans R. Figulla; Markus Ferrari
• Keywords: Impella

Acute cardiogenic shock after myocardial infarction is associated with high in-hospital mortality attributable to persisting low-cardiac output. The Impella-EUROSHOCK-registry evaluates the safety and efficacy of Impella-2.5-percutaneous left-ventricular assist device in patients acute infarction.This multicenter registry retrospectively included 120 (63.6±12.2 years; 81.7% male) from receiving temporary circulatory support device. primary end point evaluated at 30 days. secondary analyzed change plasma lactate institution hemodynamic support, rate early major adverse cardiac cerebrovascular events as well long-term survival. Thirty-day was 64.2% study population. After implantation, levels decreased 5.8±5.0 mmol/L 4.7±5.4 (P=0.28) 2.5±2.6 (P=0.023) 24 48 hours, respectively. Early were reported 18 (15%) patients. Major bleeding vascular access site, hemolysis, pericardial tamponade occurred 34 (28.6%), 9 (7.5%), 2 (1.7%) patients, parameters age >65 level >3.8 admission identified predictors 30-day mortality. 317±526 days follow-up, survival 28.3%.In infarction, Impella 2.5-treatment feasible results a reduction levels, suggesting improved organ perfusion. However, remains these This likely reflects last-resort character Impella-2.5-application selected poor profile greater imminent risk death. Carefully conducted randomized controlled trials are necessary evaluate Impella-2.5-support this high-risk patient group.