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Sustained Use of the Impella 5.0 Heart Pump Enables Bridge to Clinical Decisions in 34 Patients
Tex Heart Inst J. 2021 Jul 1;48(3):e207260. doi: 10.14503/THIJ-20-7260.ABSTRACTWe studied whether sustained hemodynamic support (>7 d) with the Impella 5.0 heart pump can be used as a bridge to clinical decisions in patients who present with cardiogenic shock, and whether such support can improve their outcomes. We retrospectively reviewed cases of patients who had Impella 5.0 support at our hospital from August 2017 through May 2019. Thirty-four patients (23 with cardiogenic shock and 11 with severely decompensated heart failure) underwent sustained support for a mean duration of 11.7 ± 9.3 days (range, ≤48 d). Of 2...
Source: Texas Heart Institute Journal - August 13, 2021 Category: Cardiology Authors: Daniel W Nelson Sakthi Sundararajan Evan Klein Lyle D Joyce Lucian A Durham David L Joyce Asim A Mohammed Source Type: research

Acute myocardial infarction in the Covid-19 era: Incidence, clinical characteristics and in-hospital outcomes —A multicenter registry
by Alexander Fardman, Doron Zahger, Katia Orvin, Daniel Oren, Natalia Kofman, Jameel Mohsen, Or Tsafrir, Elad Asher, Ronen Rubinshtein, Jafari Jamal, Roi Efraim, Majdi Halabi, Yacov Shacham, Lior Henri Fortis, Tal Cohen, Robert Klempfner, Amit Segev, Roy Beigel, Shlomi Matetzky BackgroundWe aimed to describe the characteristics and in-hospital outcomes of ST-segment elevation myocardial infarction (STEMI) patients during the Covid-19 era. MethodsWe conducted a prospective, multicenter study involving 13 intensive cardiac care units, to evaluate consecutive STEMI patients admitted throughout an 8-week period during the Covi...
Source: PLoS One - June 18, 2021 Category: Biomedical Science Authors: Alexander Fardman Source Type: research

Blood lactate predicts survival after percutaneous implantation of extracorporeal life support for refractory cardiac arrest or cardiogenic shock complicating acute coronary syndrome: insights from the CareGem registry
AbstractRefractory cardiogenic shock (RCS) or refractory cardiac arrest (RCA) complicating acute coronary syndrome (ACS) is associated with extremely high mortality rate. Veno-arterial extracorporeal life support (VA-ECLS) represents a valuable therapeutic option to stabilize patients ’ condition before or at the time of emergency revascularization. We analyzed 29 consecutive patients with RCS or RCA complicating ACS, and implanted with VA-ECLS in two centers who have adopted a similar, structured approach to ECLS implantation. Data were collected from January 2010 to December 2015 and ECLS had to be percutaneously impla...
Source: Internal and Emergency Medicine - August 8, 2020 Category: Emergency Medicine Source Type: research

Ischemic Stroke and Intracranial Hemorrhages During Impella Cardiac Support
Impella is a percutaneously placed, ventricular assist device for short-term cardiac support. We aimed to study acute neurologic complications during short-term cardiac support with Impella. We reviewed prospectively collected data of 79 consecutive persons implanted with Impella at a single tertiary center. Acute neurologic events (ANE) were defined as ischemic strokes or intracranial hemorrhages. Among those with ANE, specific causes of ischemic and hemorrhagic events were collected and discussed. Of 79 persons with Impella with median 8 days of support (range 1–33 days), six (7.5%) developed ANE at a median of 5 days ...
Source: ASAIO Journal - July 30, 2020 Category: Medical Devices Tags: Case Report Source Type: research

Integrating the STOP-BANG score and clinical data to predict cardiovascular events after infarction: A machine learning study.
Abstract BACKGROUND: Obstructive sleep apnea (OSA) conveys worse clinical outcomes in coronary artery disease patients. The STOP-BANG score is a simple tool that evaluates the risk of OSA and can be added to the large number of clinical variables and scores obtained during the management of myocardial infarction (MI) patients. Currently, machine learning (ML) is able to select and integrate numerous variables to optimize prediction tasks. RESEARCH QUESTION: Can the integration of STOP-BANG score with clinical data and scores through ML better identify patients who suffered an in-hospital cardiovascular event ...
Source: Chest - April 24, 2020 Category: Respiratory Medicine Authors: Calvillo-Argüelles O, Sierra-Fernández CR, Padilla-Ibarra J, Rodriguez-Zanella H, Balderas-Muñoz K, Arias-Mendoza MA, Martínez-Sánchez C, Selmen-Chattaj S, Dominguez-Mendez BE, van der Harst P, Juarez-Orozco LE Tags: Chest Source Type: research

Obesity Paradox in TAVR: Nationwide Study from 2011-14 Comparing Outcomes of Patients with versus without Obesity Undergoing TAVR
Obesity is associated with several cardiovascular diseases including aortic valve stenosis. Studies have demonstrated a beneficial effect of obesity on patients with cardiovascular disease, deemed the “obesity paradox.” This paradox is also present in obese patients undergoing total aortic valve replacement (TAVR) when examining both short and long-term mortality rates, although the data is conflicting. We aim to investigate the effects of obesity on mortality, length of hospital stay, and ra tes of stroke and cardiogenic shock in patients undergoing TAVR.
Source: Journal of Cardiac Failure - July 31, 2019 Category: Cardiology Authors: Hassaan B. Arshad, Aneil Bhalla, Sara Ayaz Butt, Rehan Umar, Umar Jamshed Sharif Khwaja, Hashim Jilani Tags: 385 Source Type: research

13 The shock team approach: the rationale and evidence
Cardiogenic shock (CS) is defined as a state of ineffective cardiac output caused by a cardiac disorder that results in both clinical and biochemical manifestations of inadequate tissue perfusion.1 Among patients presenting with CS, there is a spectrum of disease whereby some patients can be stabilised with pharmacologic interventions alone, while others require escalation to mechanical circulatory support (MCS).2 As patients and treatment options both become increasingly complex, comprehensive critical care may be best delivered in disease-specific service line ICUs.2 The model of the cardiac ICU has transitioned over tim...
Source: Heart Asia - April 24, 2019 Category: Cardiology Authors: Kiernan, M. S. Tags: Keynote Lecture Source Type: research

Full percutaneous biventricular support with two Impella pumps: the Bi ‐Pella approach
We report the first case of mechanical circulatory supported with Impella CP on the left and Impella RP on the right (Abiomed Inc., Danvers, MA) for acute biventricular failure due to suspected acute myocarditis in the context of thrombolytic therapy for ischaemic stroke.
Source: ESC Heart Failure - February 21, 2018 Category: Cardiology Authors: Federico Pappalardo, Anna Mara Scandroglio, Azeem Latib Tags: Case Report Source Type: research

Off-pump versus On-pump Coronary Artery Bypass Grafting in Frail Patients: Study Protocol for the FRAGILE Multicenter Randomized Controlled Trial
In this study, the authors introduce the new national, multicenter, randomized, controlled trial "FRAGILE", to be developed in the main cardiac surgery centers of Brazil, to clarify the potential benefit of off-pump CABG in frail patients. Methods: FRAGILE is a two-arm, parallel-group, multicentre, individually randomized (1:1) controlled trial which will enroll 630 patients with blinded outcome assessment (at 30 days, 6 months, 1 year, 2 years and 3 years), which aims to compare adverse cardiac and cerebrovascular events after off-pump versus on-pump CABG in pre-frail and frail patients. Primary outcomes will be all-cause...
Source: Revista Brasileira de Cirurgia Cardiovascular - December 5, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

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