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Journal of Shock and Hemodynamics

Journal

Impella

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Articles 1 - 4 of 4

Full-Text Articles in Cardiology

An Unusual Case Of Cardiogenic Shock: Coronary Artery Vasospasms, Amanda Bergeron, Maks Mihalj Apr 2024

An Unusual Case Of Cardiogenic Shock: Coronary Artery Vasospasms, Amanda Bergeron, Maks Mihalj

Journal of Shock and Hemodynamics

Coronary artery vasospasms may occur in one or multiple coronary arteries, typically causing transient chest pain or angina. Although rare, it can lead to lethal cardiac arrhythmias, cardiac arrest, or cardiogenic shock and is often misdiagnosed. We report a case of a young man with an atypical presentation of generalized coronary vasospasm leading to cardiac arrest and subsequent cardiogenic shock. The patient required support with veno-arterial extracorporeal membrane oxygenation and Impella. We discuss the risk factors, diagnosis, and treatment of this rare condition.


The Brink Of The Abyss: From Transcatheter Aortic Valve Implantation, To Impella, To Left Ventricular Assist Device Destination Therapy, Jake Kieserman, Megan Sheehan, Marisa Cevasco, Brian Mccauley, Ryan Prentice, Jay Giri, Joyce Wald Sep 2023

The Brink Of The Abyss: From Transcatheter Aortic Valve Implantation, To Impella, To Left Ventricular Assist Device Destination Therapy, Jake Kieserman, Megan Sheehan, Marisa Cevasco, Brian Mccauley, Ryan Prentice, Jay Giri, Joyce Wald

Journal of Shock and Hemodynamics

Acute valvular emergencies are common causes of cardiogenic shock. Patients with critical aortic pathologies causing shock frequently undergo percutaneous interventions for valve replacement. However, in cases of persistent cardiogenic shock after valve replacement, there are limited options for further mechanical support. In this case study, we report a patient with a prior history of aortic valve replacement who presented in cardiogenic shock. After a transcatheter aortic valve-in-valve replacement, he remained in persistent shock with worsening clinical parameters requiring escalating inotropic and vasopressor support. With input from a multidisciplinary care team, an Impella 5.5 (Abiomed, Inc.) was placed through the valve …


Management Of Patients With Refractory Cardiogenic Shock And Cardiointestinal Syndrome With Impella 5.5 As Bridge To Decision: Case Series, Ismael A. Salas De Armas, Bindu Akkanti, Amanda Bergeron, Anju Bhardwaj, Kha Dinh, Ali Shirafkan, Jayeshkumar A. Patel, Manish K. Patel, Carlos R. Manrique Neira, Igor D. Gregoric, Biswajit Kar, Mehmet H. Akay Feb 2023

Management Of Patients With Refractory Cardiogenic Shock And Cardiointestinal Syndrome With Impella 5.5 As Bridge To Decision: Case Series, Ismael A. Salas De Armas, Bindu Akkanti, Amanda Bergeron, Anju Bhardwaj, Kha Dinh, Ali Shirafkan, Jayeshkumar A. Patel, Manish K. Patel, Carlos R. Manrique Neira, Igor D. Gregoric, Biswajit Kar, Mehmet H. Akay

Journal of Shock and Hemodynamics

Patients with advanced heart failure require multi-system management as a majority succumb to end-organ dysfunction, including gastrointestinal sequelae. Temporizing measures, such as early mechanical circulatory support, can assist in the recovery of patients with acute cardiogenic shock. The temporary support can improve patient characteristics to enable future definitive heart failure therapies such as durable left ventricular assist devices and orthotopic heart transplantation. We present two cases of cardiogenic shock that were successfully bridged with an Impella 5.5 (Abiomed). The management enabled the patients to recover from reversible cardiointestinal syndrome and undergo successful definitive therapies.


Coronary Flow And Unloading In Acute Myocardial Infarction Shock, Kiyo Ishikawa Feb 2023

Coronary Flow And Unloading In Acute Myocardial Infarction Shock, Kiyo Ishikawa

Journal of Shock and Hemodynamics

In patients with cardiogenic shock that undergo successful coronary intervention, there are still factors complicating myocardial recovery. There is room for improvement in coronary flow using mechanical circulatory devices, specifically by left ventricular unloading. This idea was further explored in a research study using pigs. Results showed that subjects with acute myocardial infarction who have reduced cardiac contractility and/or high diastolic pressure would benefit from support strategies targeting left ventricular unloading.