Use of the Impella 2.5 in High-Risk Percutaneous Coronary Intervention

McCulloch, Brenda

doi:10.4037/ccn2011293

Cited by 12 publications

(8 citation statements)

References 13 publications

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“…In the US, several trials like Protect I, Protect II, ISAR-SHOCK, Recover I and Recover II trials have been sponsored by ABIOMED to help answer this questions with encouraging results [5]. It has also been shown that it can help improve coronary blood flow and cardiac output by reducing the workload and oxygen consumption of the cardiac muscle [10-12].…”

Section: Discussionmentioning

confidence: 99%

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The Duration of Impella 2.5 Circulatory Support and Length of Hospital Stay of Patients Undergoing High-risk Percutaneous Coronary Interventions

2012

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BackgroundTo evaluate the impact of duration of Impella 2.5 support (Abiomed, Danvers, MA) on hospitalization of patients after high-risk percutaneous coronary intervention (PCI). There has been a continuous increase in prevalence of coronary artery disease with more patients needing PCI during acute myocardial infarction. Some of these patients have to undergo high-risk revascularization with circulatory support like the Impella 2.5 device.MethodsThis study was a single center retrospective study of patients admitted to our hospital who required Impella circulatory support during percutaneous coronary intervention. Patients’ medical records, cardiac catheterization laboratory and 2-D echocardiography reports were reviewed to ascertain left ventricular ejection fraction, duration of Impella support, Coronary Care Unit (CCU) days and the length of stay in the hospital. A P-value of ≤ 0.05 was considered statistically significant.ResultsOver a 15-month period, we had 25 patients with 19 males and 6 females. Mean age of the patient cohort was 68 ± 10 years. Mean LVEF of the group was 32 ± 16%. Mean length of hospital stay was 8 ± 8 days and mean CCU stay was 4 ± 4 days. The Impella was successfully inserted in all cases with a median duration of support of 70 minutes (range, 4 - 5760 minutes). Bleeding complication occurred in 8%. Spearman's rank correlation coefficient between the duration of Impella support and hospital stay was 0.49 (P = 0.023) while it was 0.71 (P = 0.001) between Impella support duration and CCU days.ConclusionsOur study suggests that there is a positive correlation between the duration of Impella 2.5 circulatory support and hospital stay and/or CCU days. The correlation seems to be stronger with CCU days.

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Section: Discussionmentioning

confidence: 99%

“…It is able to achieve about 2.5 L/min of blood flow per cardiac output. The United States Food and Drug Administration approved this device in June 2008 for up to 6 hours of support [5]. However, in Europe, the device is approved for up to 5 days of partial circulatory support [5].…”

Section: Introductionmentioning

confidence: 99%

The Duration of Impella 2.5 Circulatory Support and Length of Hospital Stay of Patients Undergoing High-risk Percutaneous Coronary Interventions

2012

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“…It is approved by the Food and Drug Administration (FDA) for a total duration of 6 hours but has been used in some patients for as long as 2 weeks. The use of percutaneous LVAD devices are being used progressively more in high risk Percutaneous Coronary Intervention (PCI) procedures because they provide greater increases in cardiac output than IntraAortic Balloon Pumps (IABP) [7]. The IABP is limited in its ability to provide circulatory support and if left ventricular function is severely compromised, an IABP will not be effective [7].…”

Section: Discussionmentioning

confidence: 99%

“…The use of percutaneous LVAD devices are being used progressively more in high risk Percutaneous Coronary Intervention (PCI) procedures because they provide greater increases in cardiac output than IntraAortic Balloon Pumps (IABP) [7]. The IABP is limited in its ability to provide circulatory support and if left ventricular function is severely compromised, an IABP will not be effective [7]. The Impella  2.5 offers several advantages when compared to ECMO primarily being its ease of insertion in the catheterization laboratory.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Fulminant Myocarditis

Tucker¹,

Fernandez²,

Morrison³

2013

J Clin Case Rep

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Purpose: Myocarditis is an inflammatory process of the myocardium that can have an assortment of different etiologies such as infection, systemic disease and/or exposure to medications and toxins. There can be a variety of clinical presentations ranging from mild dyspnea and chest pain that can be self-limiting to cardiogenic shock and death. Although myocarditis can have several causes, viral infection remains the leading cause of both acute and chronic myocarditis. Corticosteroids, Intravenous Immunoglobulin (IVIG) and ventricular assist devices are controversial treatment options with minimal evidence of efficacy in the adult population. Summary:A critically ill patient presented to a large academic healthcare facility with flu-like symptoms and severe left ventricular dysfunction. The patient was given broad spectrum antimicrobials, corticosteroids and intravenous immunoglobulin as part of their treatment regimen. Due to severe left ventricular dysfunction, the patient required the use of a left ventricular assist device and extracorporeal membrane oxygenation for cardiac and hemodynamic support. After improvement in left ventricular function, the patient experience neuropathies requiring physical therapy and rehabilitation. Conclusion:This case report presents a patient with severe left ventricular dysfunction due to myocarditis. After administration of broad antimicrobial coverage, corticosteroids and IVIG, our patient experienced recovery of left ventricular function and overall improvement in his condition.

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“…For example, the Abiomed Impella pump, which is used to treat patients with cardiogenic shock, has helically shaped impeller blades and a standard stent with straight filaments. 2 The protective cage or stent around current intravascular pumps is not designed to maximize energy transfer but, rather, to minimize manufacturing effort. To improve flow control and energy transfer, we evaluated the inclusion of a uniquely shaped protective cage to advance the current state-of-the-art and create a new intravascular blood pump as a therapeutic option for patients with ailing singleventricle physiology.…”

mentioning

confidence: 99%