PMID- 35895984
OWN - NLM
STAT- MEDLINE
DCOM- 20230314
LR  - 20230315
IS  - 1678-9741 (Electronic)
IS  - 0102-7638 (Print)
IS  - 0102-7638 (Linking)
VI  - 38
IP  - 1
DP  - 2023 Feb 10
TI  - Use of Impella Devices for Acute Cardiogenic Shock in the Perioperative Period of 
      Cardiac Surgery.
PG  - 71-78
LID - 10.21470/1678-9741-2021-0398 [doi]
AB  - INTRODUCTION: The Impella ventricular support system is a device that can be 
      inserted percutaneously or directly across the aortic valve to unload the left 
      ventricle. The purpose of this study is to determine the role of Impella devices 
      in patients with acute cardiogenic shock in the perioperative period of cardiac 
      surgery. METHODS: A retrospective single-surgeon review of 11 consecutive 
      patients who underwent placement of Impella devices in the perioperative period 
      of cardiac surgery was performed. Patient records were evaluated for 
      demographics, indications for placement, and postoperative outcomes. RESULTS: 
      Impella devices were placed for refractory cardiogenic shock preoperatively in 6 
      patients, intraoperatively in 4 patients, and postoperatively as a rescue in 1 
      patient. Seven patients received Impella CP, 1 Impella RP, 1 Impella CP and RP, 
      and 2 Impella 5.0. Additionally, 3 patients required preoperative venovenous 
      extracorporeal membrane oxygenation (VV-ECMO), and 1 patient required 
      intraoperative venoarterial extracorporeal membrane oxygenation (VA-ECMO). All 
      Impella devices were removed 1 to 28 days after implantation. Length of stay in 
      the intensive care unit stay ranged from 2 to 53 days (average 23.9+/-14.6). The 
      30-day and 1-year mortality were 0%. Ten of 11 patients were alive at 2 years. 
      Also, 1 patient died 18 months after surgery from complications of coronavirus 
      disease (Covid-19). Device-related complications included varying degrees> of 
      hemolysis in 8 patients (73%) and device malfunction in 1 patient (9%). 
      CONCLUSIONS: The Impella ventricular support system can be combined with other 
      mechanical support devices for additional hemodynamic support. All patients 
      demonstrated myocardial recovery with no deaths in the perioperative period and 
      in 1-year of follow-up. Larger studies are necessary to validate these findings.
FAU - Sicouri, Serge
AU  - Sicouri S
AD  - Lankenau Institute for Medical Research, Wynnewood, PA, USA.
FAU - Shah, Vishal N
AU  - Shah VN
AD  - Department of Cardiothoracic Surgery, University of Nebraska Medical Center, 
      Omaha, Nebraska.
FAU - Buckley, Meghan
AU  - Buckley M
AD  - Lankenau Institute for Medical Research, Wynnewood, PA, USA.
FAU - Imperato, Nicholas
AU  - Imperato N
AD  - Lankenau Institute for Medical Research, Wynnewood, PA, USA.
FAU - McGee, Jacqueline
AU  - McGee J
AD  - Department of Cardiothoracic Surgery, Thomas Jefferson University Hospital, 
      Philadelphia, Pennsylvania.
FAU - Casanova, Elena
AU  - Casanova E
AD  - Division of Cardiology, Lankenau Medical Center, Wynnewood, PA, USA.
FAU - Gnall, Eric
AU  - Gnall E
AD  - Division of Cardiology, Lankenau Medical Center, Wynnewood, PA, USA.
FAU - Plestis, Konstadinos A
AU  - Plestis KA
AD  - Department of Cardiothoracic Surgery, Thomas Jefferson University Hospital, 
      Philadelphia, Pennsylvania.
LA  - eng
PT  - Journal Article
DEP - 20230210
PL  - Brazil
TA  - Braz J Cardiovasc Surg
JT  - Brazilian journal of cardiovascular surgery
JID - 101677045
SB  - IM
MH  - Humans
MH  - Shock, Cardiogenic/etiology
MH  - Retrospective Studies
MH  - *Heart-Assist Devices/adverse effects
MH  - *COVID-19/complications
MH  - *Cardiac Surgical Procedures/adverse effects
MH  - Postoperative Period
MH  - Treatment Outcome
PMC - PMC10010704
OTO - NOTNLM
OT  - Aortic Valve
OT  - Cardiac Surgical Procedures
OT  - Cardiogenic
OT  - Extracorporeal Membrane Oxygenation
OT  - Heart Ventricles
OT  - Hemodynamics
OT  - Perioperative Period.
OT  - Shock
COIS- No conflict of interest.
EDAT- 2022/07/28 06:00
MHDA- 2023/03/15 06:00
PMCR- 2023/01/01
CRDT- 2022/07/27 16:07
PHST- 2022/07/28 06:00 [pubmed]
PHST- 2023/03/15 06:00 [medline]
PHST- 2022/07/27 16:07 [entrez]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.21470/1678-9741-2021-0398 [doi]
PST - epublish
SO  - Braz J Cardiovasc Surg. 2023 Feb 10;38(1):71-78. doi: 
      10.21470/1678-9741-2021-0398.