0050: Impella 2.5 in acute myocardial infarction complicated by cardiogenic shock: experience from Bordeaux - 07/02/15
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Résumé |
Background |
Cardiogenic shock, mainly due to an acute coronary syndrome (ACS), is still subject to a high mortality despite early coronary revascularization. Nowadays, transient percutaneous left ventricular assist device, like Impella 2.5 (Abiomed®), would improve the hemodynamic situation and the survival.
Methods |
In our institution, all the patients treated with Impella 2.5 as first line therapy for a cardiogenic shock consecutive to ACS were retrospectively included. The mortality at day 30, the hemodynamic efficacy and complications have been analyzed.
Results |
From July 2008 to December 2012, 22 patients (13 men, 58±11 years) with cardiogenic shock (LV Ejection Fraction 26±8%; SOFA 9.2±4; cardiac index (CI) 2.1±0.4L/min/m2) were included (12 cardiac arrest, 59% STEMI).The Impella 2.5 device provided effective hemodynamic support (CI increased by 16%, lung and capillary pressures respectively reduced by 36% and 28%). Survival at day 30 was 59%, and it has been maintained up to 6 months. Factors associated with mortality were incomplete revascularization (p<0.01), age >70 years (p=0.07), a SOFA score ≥9 (p =0.02) and blood lactate >6.3mmol/L (p=0.07) at implantation.
Conclusion |
This couraging results in our single-center experience should be confirmed by a randomized controlled trial.
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Vol 7 - N° 1
P. 107-108 - janvier 2015 Retour au numéro
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