Document Detail


Important role of mechanical circulatory support in acute myocardial infarction complicated by cardiogenic shock.
MedLine Citation:
PMID:  25480935     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: Acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) remains associated with significant mortality despite the widespread application of early revascularization strategies. Recent evidence suggests that the use of intra-aortic balloon pump (IABP) counterpulsation does not improve mortality in this cohort of patients. We summarize our experience with mechanical circulatory support (MCS) therapy for AMI/CS.
METHODS: This is a retrospective review of 61 patients who received MCS therapy for AMI/CS at our institution between March 2007 and March 2013.
RESULTS: Mean age was 60.2 ± 10.3 years; mean ejection fraction was 24 ± 15% and 29% of patients were receiving active cardiopulmonary resuscitation at the time of support initiation. Prior to the initiation of MCS, 70.5% of patients had an IABP. Mean arterial pressure improved significantly with MCS (63 mmHg prior to MCS, 82 mmHg after MCS, P ≤ 0.01). Mean length of support was 9.5 ± 11.0 days, and overall survival to 30 days was 59.0%. Among 30-day survivors, 44.4% required device exchange to a durable MCS device. Ultimately, only 31% (52.8% of patients who survived to 30 days) achieved myocardial recovery.
CONCLUSIONS: Short-term MCS therapy with subsequent aggressive use of durable MCS device may improve the unacceptably high mortality rate in AMI/CS. Rigorous prospective studies of MCS therapy in AMI/CS are warranted.
Authors:
Lauren Truby; Yoshifumi Naka; Bindu Kalesan; Takeyoshi Ota; Ajay J Kirtane; Susheel Kodali; Natasha Nikic; Lily Mundy; Paolo Colombo; Ulrich P Jorde; Hiroo Takayama
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-12-4
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  -     ISSN:  1873-734X     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2014 Dec 
Date Detail:
Created Date:  2014-12-6     Completed Date:  -     Revised Date:  2014-12-7    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
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