1. Retrospective analysis of circulatory support with the Impella CP® device in patients with therapy refractory cardiogenic shock
- Author
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Axel Bauer, Julinda Mehilli, Bruno C. Huber, Steffen Massberg, Korbinian Lackermair, Stefan Brunner, Hans D. Theiss, Stefan M. Sattler, Ulrich Grabmaier, Ludwig T. Weckbach, and Jörg Hausleiter
- Subjects
Adult ,Male ,medicine.medical_specialty ,Acute coronary syndrome ,medicine.medical_treatment ,Shock, Cardiogenic ,030204 cardiovascular system & hematology ,Cohort Studies ,03 medical and health sciences ,Extracorporeal Membrane Oxygenation ,0302 clinical medicine ,medicine ,Extracorporeal membrane oxygenation ,Humans ,030212 general & internal medicine ,Survival rate ,Impella ,Aged ,Retrospective Studies ,business.industry ,Cardiogenic shock ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Haemolysis ,Surgery ,Survival Rate ,SAPS II ,Female ,Heart-Assist Devices ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background In cardiogenic shock (CS) the Impella CP® device provides a fast available left ventricular circulatory support of up to 4.0L/min. However, the use of the Impella CP® device was not systematically analysed yet. Methods We performed a retrospective analysis of 28 consecutive patients suffering from severe therapy refractory CS treated with Impella CP®. Mortality was estimated using the SAPS II-Score. Primary outcome was 30-day survival. We compared the different aetiologies of CS and the effect of additional extracorporeal life support (ECLS). Results Aetiology of CS was acute coronary syndrome (ACS) in 15 patients, 9 patients received additional therapy with ECLS. SAPS II was 73±14, representing an estimated mortality of 87.1%. 18 patients deceased representing a 30-day survival of 36%. Comparing the different aetiologies, ACS-CS patients show a trend towards better survival. Additional therapy with ECLS did not change 30-day survival. In 3 cases, vascular complication needing surgical treatment occurred. All other patients showed no relevant complications except for the commonly seen haemolysis with consecutive need of transfusion. Conclusion Our data could demonstrate that the Impella CP ® application in these severely diseased patients is feasible and safe. Compared to the estimated mortality, the 30-day survival seems to be improved.
- Published
- 2016