Category: Cardiogenic Shock


Identifying Cardiogenic Shock Early with a Heart Team Approach

Dr. Alexander Truesdell, Interventional Cardiologist at Inova Heart and Vascular Institute discusses his editorial, the War on Shock, published in the Journal of Invasive Cardiology. The editorial compares his experience as a military physician with his experience as a cardiologist treating cardiogenic shock. Watch the video to learn which systems of care Dr. Truesdell suggests … Continue reading “Identifying Cardiogenic Shock Early with a Heart Team Approach”

Importance of Right Heart Catheterization

Dr. Susan Joseph, Advanced Heart Failure Specialist from Baylor University Medical Center, discusses perspectives on management of Impella patients in critical care units, particularly the use of invasive hemodynamic monitoring. PA catheters, or right heart catheterization, provide a minute to minute constant source of information about a patient with shock and their filling pressures, pulmonary … Continue reading “Importance of Right Heart Catheterization”

Early Impella Support Associated with Increased Survival in Cardiogenic Shock

Key Takeaways

  • This retrospective study evaluated observational data of patients receiving either early or delayed initiation of Impella for the management of acute myocardial infarction complicated by cardiogenic shock (AMICS).
  • Receiving mechanical circulatory support (MCS) prior to percutaneous coronary intervention (PCI) compared with post-PCI initiation was associated with a higher survival rate to discharge among AMICS patients.
  • Overall survival to discharge for the cohort was 44%.
  • Additionally, early initiation of MCS at the first signs of shock and before inotropes, vasopressors, and PCI correlated with a higher rate of survival.
The use of mechanical circulatory support (MCS) in cardiogenic shock (CS) has been consistently shown to correlate with improved survival and assist interventionalists achieve complete revascularization.1,2,3 The use of MCS devices for the treatment of acute myocardial infarction complicated by cardiogenic shock (AMICS) may also provide hemodynamic support for some patients.4 Continue readingEarly Impella Support Associated with Increased Survival in Cardiogenic Shock

Considerations for Impella vs. ECMO

Dr. Michael Tong, Director of Heart Transplantation; Dr. Edward Soltesz, Surgical Director; and Dr. Shinya Unai, Cardiovascular and Thoracic Surgeon all of the Cleveland Clinic join Dr. Dan Raess to discuss considerations for when ECMO is the right choice and when Impella is the right choice for their patients. Clinicians today have different mechanical circulatory … Continue reading “Considerations for Impella vs. ECMO”

Improving Survival in Cardiogenic Shock by Adopting a Uniform Approach to Systems of Care

Reference: J Am Coll Cardiol 2018; 72:1972-80 Cardiogenic shock continues to be the leading cause of death in patients with acute myocardial infarction (AMI).1 Despite implementation of guideline-recommended early revascularization, mortality rates in AMI complicated by cardiogenic shock (AMICS) remains constant at about 50%. Given that about 60,000 patients with AMI develop CS every year,2 … Continue reading “Improving Survival in Cardiogenic Shock by Adopting a Uniform Approach to Systems of Care”

The Door-to-Unloading (DTU) STEMI Safety & Feasibility Trial

Navin Kapur, MD, executive director of the CardioVascular Center for Research and Innovation at Tufts Medical Center, discusses the results of the FDA STEMI Door-to-Unloading safety and feasibility randomized controlled trial. These results were presented at the American Heart Association Scientific Sessions 2018 in Chicago on Sunday, November 11. What did we learn from this pilot … Continue reading “The Door-to-Unloading (DTU) STEMI Safety & Feasibility Trial”

Best Practice Protocols for Cardiogenic Shock Showing Improved Outcomes Within the WellStar System

Dr. Salvatore Mannino, Director of the Short-Term Mechanical Circulatory Support Program at WellStar Health System joins Dr. Seth Bilazarian to discuss how his team has implemented a cardiogenic shock protocol that has shown to improve patient outcomes. Part of the protocol includes the following best practices: Safe femoral practices for large bore access Pre-PCI hemodynamic … Continue reading “Best Practice Protocols for Cardiogenic Shock Showing Improved Outcomes Within the WellStar System”