Percutaneous hemodynamic support (Impella) in patients with advanced heart failure and/or cardiogenic shock not eligible to PROTECT II trial

Wei Liu, Venkata Kishore Mukku, Syed Gilani, Kenichi Fujise, Alejandro Barbagelata

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

PROTECT I and II trials have tested the efficacy of Impella in patents with high-risk percutaneous coronary intervention (PCI). However, patients with severe hemodynamic instability such as cardiac arrest, ST-segment elevated myocardial infarction (STEMI), or cardiogenic shock were excluded. The objective was to investigate the efficacy of Impella in sicker patient population who were not included in PROTECT trials. These patients merit high-risk PCI who had cardiogenic shock and unstable or decompensated heart failure (HF). From December 2010 to March 2012, 10 consecutive patients with extremely high surgical risk and hemodynamic instability underwent urgent PCI with Impella 2.5 support (Abiomed Inc., Danvers, MA). These patients were presented with advance HF and/or cardiogenic shock. Among the 10 included patients, 3 patients were with cardiac arrest and 1 patient was with acute myocardial infarction. All patients had successful Impella implantation and remained hemodynamically stable during high-risk PCI. Among the 10 patients 2 patients (20%) died within 1 month and 1 patient developed limb ischemia. In high-risk population nonrandomizable to PROTECT trials with advance HF/cardiogenic shock, Impella could be an important tool for hemodynamic support to PCI or could be a bridge to left ventricle assist device to achieve good recovery. Larger studies need to be conducted on this high-risk population.

Original languageEnglish (US)
Pages (from-to)207-212
Number of pages6
JournalInternational Journal of Angiology
Volume22
Issue number4
DOIs
StatePublished - Dec 2013

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Cardiogenic Shock
Heart Failure
Hemodynamics
Percutaneous Coronary Intervention
Heart Arrest
Population
Heart-Assist Devices
Patents
Heart Ventricles
Ischemia
Extremities
Myocardial Infarction

Keywords

  • cardiogenic shock
  • heart failure
  • left ventricle assisting device
  • percutaneous coronary intervention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Percutaneous hemodynamic support (Impella) in patients with advanced heart failure and/or cardiogenic shock not eligible to PROTECT II trial. / Liu, Wei; Mukku, Venkata Kishore; Gilani, Syed; Fujise, Kenichi; Barbagelata, Alejandro.

In: International Journal of Angiology, Vol. 22, No. 4, 12.2013, p. 207-212.

Research output: Contribution to journalArticle

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