Treatment of acute limb ischemia in an Impella CP patient

2019 ◽  
Vol 42 (9) ◽  
pp. 525-527 ◽  
Author(s):  
Christian Flottmann ◽  
Martin Braun ◽  
Marco Köster ◽  
Volker Rudolph
Keyword(s):  
Cardiogenic Shock ◽  
Left Ventricular Assist Device ◽  
Limb Ischemia ◽  
Left Ventricular ◽  
Acute Limb Ischemia ◽  
Arterial Cannulation ◽  
Assist Device ◽  
Ventricular Assist ◽  
Left Ventricular Assist ◽  
Ischemic Complications

The use of the Impella left ventricular assist device is feasible in severe cardiogenic shock. Ischemic complications due to the arterial cannulation may occur. The following case shows how the use of a perfusion adapter for antegrade leg perfusion treats ischemia of the lower extremities.

Outcome of Temporary Circulatory Support As a Bridge-to-Left Ventricular Assist Device Strategy in Cardiogenic Shock Patients

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Auriane Bidaut ◽  
Erwan Flécher ◽  
Nicolas Nesseler ◽  
Karl Bounader ◽  
André Vincentelli ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
Circulatory Support ◽  
Assist Device ◽  
Ventricular Assist ◽  
Left Ventricular Assist

scholarly journals Percutaneous left ventricular assist support is associated with less pulmonary congestion and lower rate of pneumonia in patients with cardiogenic shock

Open Heart ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e001385
Author(s):  
Sandra Haberkorn ◽  
Angelika Uwarow ◽  
Jean Haurand ◽  
Christian Jung ◽  
Malte Kelm ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
Apache Ii Score ◽  
Pulmonary Congestion ◽  
Assist Device ◽  
Ventricular Assist ◽  
Left Ventricular Assist ◽  
The Impact

ObjectivesThe aim of this study was to investigate the impact of acute left ventricular unloading by percutaneous left ventricular assist device on pulmonary congestion and pneumonia in patients with cardiogenic shock (CS).MethodsIn this retrospective study, we analysed patients with CS who received the Impella percutaneous left ventricular assist device (n=50) compared with those who received intra-aortic balloon pump (IABP) support (n=50). Pulmonary congestion was longitudinally assessed while on support by calculating characteristic findings on the chest X-ray using the Halperin score. The rate of pneumonia and early mortality were assessed as a secondary endpoint.ResultsThe groups (Impella vs IABP) did not differ in terms of age, Sequential Organ Failure Assessment (SOFA) score, Acute Physiology, Chronic Health Evaluation (APACHE) II score or serum lactate levels. Pulmonary congestion decreased in patient treated with Impella at each time point postimplantation. No change in congestion status was observed in patients supported with IABP. Multivariate analysis indicated Impella support as an independent predictor for pulmonary decongestion (OR 4.06, 95% CI 1.15 to 14.35, p=0.030). The rate of early pneumonia was lower in the Impella group compared with the IABP group (54% vs 74%, p=0.037). Failure of pulmonary decongestion during mechanical circulatory support independently predicted early pneumonia (OR 0.28, 95% CI 0.12 to 0.70, p=0.006).ConclusionPulmonary decongestion may facilitate treatment of pneumonia in patients with CS. Left ventricular unloading by Impella device might support pulmonary decongestion, although a larger prospective trial in this patient population is required.

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