Top Cardiogenic Shock Treatment Objectives and Device Options
In patients with acute myocardial infarction (AMI), cardiogenic shock (CS) is a primary cause of mortality. According to ACC.org’s “Latest in Cardiology”, AMI with CS presents three main treatment objectives, all of which can be achieved with acute mechanical circulatory support devices:
- Achieve a mean arterial pressure and vital organ perfusion,
- Reduce myocardial oxygen demand via ventricular unloading, and
- Recanalize an occluded coronary vessel to augment myocardial perfusion and minimize burden of myocardial injury.
Hemodynamic support is recommended for patients with CS who fail to improve with medication therapy. Further guidelines suggest the elective insertion of a hemodynamic support device in CS patients as a complementary approach to PCI. While these guidelines may be helpful for some patients, the lack of controlled, randomized trials demonstrating hemodynamic support is worth noting. Intra-aortic balloon pumps (IABPs) are devices that have been rigorously studied for cardiogenic shock, yet their utility in CS is somewhat limited. The Impella CP® from Abiomed has shown some hemodynamic superiority over IABP therapy, with one large study demonstrating a 60% rate of 30-day survival in 117 CS patients.
To learn more about the Impella® platform of heart pumps, including important risk and safety information associated with the use of the devices, please visit: www.protectedpci.com/indications-use-safety-information/