Percutaneous left ventricular assist in ischemic cardiac arrest

Abstract

During VF, a percutaneous LVAD may sustain vital organ perfusion. A potential clinical role of the device during cardiac arrest has yet to be established.

Doubling survival and improving clinical outcomes using a left ventricular assist device instead of chest compressions for resuscitation after prolonged cardiac arrest: a large animal study

“…Although the use of the Impella system has been extensively described in several cases of advanced cardiac failure [ 36 ], there are only a few reported studies of its use in the context of cardiac arrest, predominantly in post-cardiac arrest patients presenting with low cardiac output syndrome or recurring episodes of VF [ 37 ]. In three animal studies, Tuseth and colleagues showed that cerebral and myocardial perfusion could be significantly improved compared with open-chest cardiac compressions for up to 45 minutes [ 16 , 38 , 39 ]. However, they did not report whether this therapy had an influence on survival or neurological outcome in a closed-chest model of cardiac arrest and CPR.…”

“…Second, we did not directly measure cerebral or coronary blood flow during CPR, which has been extensively reported by Tuseth and colleagues in an open-chest cardiac arrest model [ 16 , 38 , 39 ]. However, because we decided to focus on resuscitation success and clinical outcomes, we were obliged to avoid invasive measurements that may have compromised survival itself.…”

Treatment of cardiogenic shock with left ventricular assist device combined with cardiac resynchronization therapy: A case report

“…Small studies comparing IABP and Impella in cardiogenic shock may indicate beneficial hemodynamic effects of the percutaneous LVAD [3,4]. Experimental studies have shown that Impella LP 2.5 ® may sustain vital organ perfusion even during cardiac arrest [6]. Thus, the percutaneous LVAD may have potential to significantly improve hemodynamics in selected critically ill patients.…”

Percutaneous left ventricular assist devices during cardiogenic shock and high-risk percutaneous coronary interventions

“…In summary, pVADs are effective tools for rapid hemodynamic stabilization in patients presenting with cardiogenic shock, and usually maintain vital organ perfusion even in case of cardiac arrest [25]. Although improvement of hemodynamic parameters by means of pVAD implantation are favorable compared with support by an IABP alone, it remains to be determined whether this benefi t translates into improved clinical outcome.…”