A young man with biventricular dysfunction and severe malperfusion to multiple organs is put on ECMO and Impella support. Despite Impella malfunction and subsequent stroke, he recovered to undergo heart-kidney transplant.
In a major new review, members of Cleveland Clinic’s cardiogenic shock team share their approach to a long-unaddressed issue: when and how to wean patients from temporary mechanical circulatory support.
Enthusiasm for the use of temporary hemodynamic support must be tempered by the lack of randomized evidence of a mortality benefit in this setting.
A prospective study finds that use of a four-point protocol for STEMI management significantly drove down rates of cardiogenic shock and improved outcomes in patients presenting with it.
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ECMO and other forms of mechanical circulatory support have a role in cases involving either respiratory failure or cardiac failure, but generally not both. An expert surgeon reviews management strategies.
A large case series shows that catheter ablation of refractory ventricular arrhythmia in patients with cardiogenic shock can allow for liberation from mechanical support in most cases.
We’ve been pioneering use of the Impella 5.0 temporary LVAD to support patients with cardiogenic shock who need salvage ablation for ventricular tachycardia. This case study shares lessons learned to date.
This unprecedented case report shows that, in the right patients, biventricular support with Impella devices can minimize the risk of complications and reduce transplant recovery time.
This long-overdue set of comprehensive recommendations advocates for creation of regionalized hub-and-spoke systems for care of refractory cardiogenic shock cases.