Impella Bleeding, Mortality'Signals' in MI-Shock, High-Risk PCI Impella Bleeding, Mortality'Signals' in MI-Shock, High-Risk PCI

Is it reality-check time for aficionados of Impella ventricular-assist pumps in cardiogenic shock or supported PCI? New observational data raise cautions given the thin randomized trial support.Medscape Medical News
Source: Medscape Critical Care Headlines - Category: Intensive Care Tags: Cardiology News Source Type: news

Related Links:

Conclusion: AF may be related with worse outcomes in patients undergoing MC implantation, including long-term mortality, major bleeding, and rehospitalization. AF should be taken into account when referring a patient for MC treatment.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research
ConclusionOur results demonstrate an excellent outcome with the use of the CentriMag ™ device in this seriously ill population. Despite requiring multiple procedures, over 58% of patients were discharged from hospital with 5-year survival of 46%.
Source: Indian Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Conclusion LMWH could reduce the risk of major bleeding in patients receiving IABP. Whether LMWH could reduce arterial thromboembolism needs further investigation. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  open access Full text
Source: The Thoracic and Cardiovascular Surgeon - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Original Cardiovascular Source Type: research
Abstract PURPOSE: Thrombocytopenia (platelet count
Source: Yonsei Medical Journal - Category: Universities & Medical Training Authors: Tags: Yonsei Med J Source Type: research
Authors: Laimoud M, Alanazi M Abstract Background: Venoarterial ECMO is increasingly used in resuscitation of adult patients with cardiogenic shock with variable mortality reports worldwide. Our objectives were to study the variables associated with hospital mortality in adult patients supported with VA-ECMO and to determine the validity of repeated assessments of those patients by the Sequential Organ Failure Assessment (SOFA) score for prediction of hospital mortality. We retrospectively studied adult patients admitted to the cardiac surgical critical care unit with cardiogenic shock supported with VA-ECMO from J...
Source: Critical Care Research and Practice - Category: Intensive Care Tags: Crit Care Res Pract Source Type: research
Introduction: The clinical impact of invasive hemodynamic support with Impella in patients with cardiogenic shock (CS) remains to be defined.Methods: Only studies including patients treated with Impella in CS were selected. The primary endpoint was short term mortality, while secondary endpoints were major vascular complications and major bleeding.Results: 17 studies and 3933 patients were included in the analysis. Median age was 61.9 (IQR 59.2 –63.5) years, CS was mainly related to acute coronary syndrome (ACS): 79.6% (IQR 75.1–79.6).
Source: International Journal of Cardiology - Category: Cardiology Authors: Source Type: research
In this report, we describe two patients with heparin-induced thrombocytopenia (HIT) supported with an Impella using a bivalirudin-containing purge solution. Case 1 involved a 39-year-old man with cardiogenic shock, initially implanted with an intraaortic balloon pump, who developed HIT early in his hospital course. His worsening hemodynamics necessitated the placement of an Impella and later venoarterial extracorporeal membrane oxygenation until he eventually underwent durable left VAD implantation. Case 2 involved a 69-year-old man who had an Impella implanted for worsening cardiogenic shock. HIT was suspected shortly af...
Source: ASAIO Journal - Category: Medical Devices Tags: Case Reports Source Type: research
Conclusion and Relevance: Based on our findings, the device thrombosis rate was 2% and the rate of major bleeding (BARC 3a and higher) was 35%. This study provides descriptive outcomes data of a lower-concentration heparin purge solution. PMID: 32741200 [PubMed - as supplied by publisher]
Source: The Annals of Pharmacotherapy - Category: Drugs & Pharmacology Authors: Tags: Ann Pharmacother Source Type: research
In Reply Dr Ravn and colleagues note several limitations of observational studies. The potential for unmeasured confounding and lack of hemodynamic and metabolic parameters were discussed in the article. Nonetheless, real-world studies, including our analysis, provide important insights into the performance of mechanical circulatory support devices in routine practice. Moreover, the association of intravascular microaxial LVAD use with significantly higher rates of in-hospital mortality and major bleeding compared with IABP among patients with acute myocardial infarction complicated by cardiogenic shock was consistent acro...
Source: JAMA - Category: General Medicine Source Type: research
To the Editor Dr Dhruva and colleagues reported a higher risk of in-hospital death and bleeding complications in patients treated with an Impella device (intravascular microaxial left ventricular assist device [LVAD]) compared with an intra-aortic balloon pump (IABP) among patients with cardiogenic shock. Randomized clinical trials (RCTs) are expensive and time consuming; while trials are being conducted, retrospective observational studies can provide some insight. In cardiogenic shock, outcome is related to hemodynamic and metabolic state at the time of diagnosis. In this respect, registry data do not provide sufficient ...
Source: JAMA - Category: General Medicine Source Type: research
More News: Bleeding | Cardiogenic Shock | Cardiology | Heart | Intensive Care