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Yang W, He X, Wang Z, Lu L, Zhou G, Cheng J, Hao X. Research focus and theme trend on fulminant myocarditis: A bibliometric analysis. Front Cardiovasc Med 2022; 9:935073. [PMID: 36187003 PMCID: PMC9515361 DOI: 10.3389/fcvm.2022.935073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/19/2022] [Indexed: 11/13/2022] Open
Abstract
AimsThis study intends to explore the research focus and trends of fulminant myocarditis (FM) to have a better understanding of the topic.Materials and methodsThe data were downloaded from the Web of Science (WoS) database using the topic (TS) advanced search strategy. Many instruments were used to extract, analyze, and visualize the data, such as Microsoft Excel, HistCite Pro, GunnMap, BibExcel, and VOSviewer.ResultsFrom 1985 to 2022, 726 documents were indexed in the WoS. The United States and Columbia University were the most productive country and institutions. Keywords co-occurrence was carried out and four research themes were identified. In addition, the top three prolific authors, the first three highly cited authors, and the core authors of the author co-citation network were identified. The topics that they kept an eye on were analyzed, and the research areas of key authors were similar to the results of keyword co-occurrence. The hot topics of FM were related to the mechanical circulatory support, etiology, diagnosis, and the disease or therapy associated with FM.ConclusionThis study carried out a systematic analysis of the documents related to FM from 1985 to 2022, which can provide a guideline for researchers to understand the theme trend to promote future research to be carried out.
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Affiliation(s)
- Weimei Yang
- Department of Cardiovascular Diseases, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xifei He
- Department of Cardiovascular Diseases, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Xifei He,
| | - Zhaozhao Wang
- Department of Cardiovascular Diseases, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Zhaozhao Wang,
| | - Lijuan Lu
- Department of Cardiovascular Diseases, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ge Zhou
- Department of Cardiovascular Diseases, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jie Cheng
- Department of Cardiovascular Diseases, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinying Hao
- School of Humanities and Social Sciences, University of Science and Technology of China, Hefei, China
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Rohm CL, Gadidov B, Leitson M, Ray HE, Prasad R. Predictors of Mortality and Outcomes of Acute Severe Cardiogenic Shock Treated with the Impella Device. Am J Cardiol 2019; 124:499-504. [PMID: 31262498 DOI: 10.1016/j.amjcard.2019.05.039] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 04/30/2019] [Accepted: 05/07/2019] [Indexed: 10/26/2022]
Abstract
The Impella (Abiomed, Danvers, Massachusetts) device is increasingly used for mechanical circulatory support (MCS) to treat acute severe cardiogenic shock (CS). Initial and continued determination of the appropriate degree of MCS is challenging. This study evaluates predictors of mortality in patients treated with the Impella for acute severe CS and outcomes associated with prolonged Impella use. This retrospective single-center study included 204 patients treated with the Impella 2.5, Impella CP, or Impella 5.0 from 2011 to 2018 for acute severe CS. The primary end point was all-cause in-hospital mortality. All-cause in-hospital mortality was 45.1%. Nonsurvivors had a lower initial pH (7.24 vs 7.32, hazard ratio [HR] 1.03, p <0.0001), lower serum CO2 (19.1 vs 21.3 mmol/L, HR 1.08, p = 0.002), higher lactate (6.8 vs 3.3 mmol/L, HR 1.17, p <0.0001), and used a greater number of vasopressors and inotropes (4.3 vs 2.6, HR 1.44, p <0.0001). Patients with the Impella >4 days (n = 45) had a longer intensive care unit stay (12.6 vs 6.9 days, p <0.001), longer total hospital stay (16.4 vs 11.6 days, p = 0.03), longer mechanical ventilation use (7.8 vs 4.4 days, p = 0.002), and trend toward increased mortality (57.8 vs 41.5%, p = 0.051). In conclusion, in patients treated with the Impella for acute severe CS, initial biochemical parameters and need for vasopressors and inotropes are significant predictors of mortality that can serve as valuable indicators of whether the Impella or higher level of MCS is more appropriate. Patients treated with the Impella beyond 4 days have poorer outcomes and may benefit from escalation of care.
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3
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Tomioka T, Shimada S, Ito Y, Inoue K. Myocardial depression induced by severe sepsis: successful rescue using extracorporeal cardiopulmonary resuscitation from initial phase of severe sepsis. BMJ Case Rep 2015; 2015:bcr-2015-210185. [PMID: 26163554 DOI: 10.1136/bcr-2015-210185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
A 60-year-old man was diagnosed with severe sepsis caused by pyelonephritis. During transfer to the hospital room, he suddenly developed ventricular fibrillation and the patient recovered after electrical defibrillation. After this cardiac event, his haemodynamics collapsed despite administration of crystalloid fluid. Transthoracic echocardiography was immediately performed showing the oedema and reduced left ventricular wall motion. Since the haemodynamic collapse was too severe to maintain with conventional septic shock therapy, we introduced extracorporeal cardiopulmonary resuscitation, bridging to administration of antibiotics. As a result of these combined therapies, the patient was successfully resuscitated. From this clinical course, we finally diagnosed that the severe sepsis was concomitant with myocardial depression. Introduction of mechanical support, including extracorporeal cardiopulmonary resuscitation may be recommendable in cases of severe sepsis with myocardial depression resulting in haemodynamic collapse, however, the option of introduction of an invasive approach needs further examination.
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Affiliation(s)
- Tomoko Tomioka
- Department of Cardiology, South Miyagi Medical Center, Shibata-gun, Miyagi, Japan
| | - Satoshi Shimada
- Department of Cardiology, South Miyagi Medical Center, Shibata-gun, Miyagi, Japan
| | - Yoshitaka Ito
- Department of Cardiology, South Miyagi Medical Center, Shibata-gun, Miyagi, Japan
| | - Kanichi Inoue
- Department of Cardiology, South Miyagi Medical Center, Shibata-gun, Miyagi, Japan
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Gilotra NA, Stevens GR. Temporary mechanical circulatory support: a review of the options, indications, and outcomes. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2015; 8:75-85. [PMID: 25674024 PMCID: PMC4317108 DOI: 10.4137/cmc.s15718] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Revised: 11/18/2014] [Accepted: 11/20/2014] [Indexed: 12/20/2022]
Abstract
Cardiogenic shock remains a challenging disease entity and is associated with significant morbidity and mortality. Temporary mechanical circulatory support (MCS) can be implemented in an acute setting to stabilize acutely ill patients with cardiomyopathy in a variety of clinical situations. Currently, several options exist for temporary MCS. We review the indications, contraindications, clinical applications, and evidences for a variety of temporary circulatory support options, including the intra-aortic balloon pump (IABP), extracorporeal membrane oxygenation (ECMO), CentriMag blood pump, and percutaneous ventricular assist devices (pVADs), specifically the TandemHeart and Impella.
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Affiliation(s)
- Nisha A Gilotra
- Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Gerin R Stevens
- Mechanical Circulatory Support Program, Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, USA
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Usage of Percutaneous Left Ventricular Assist Devices in Clinical Practice and High-risk Percutaneous Coronary Intervention. Interv Cardiol Clin 2013; 2:417-428. [PMID: 28582103 DOI: 10.1016/j.iccl.2013.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Patients who require coronary revascularization and present with poor left ventricular function and complex coronary anatomy are at high risk for percutaneous coronary intervention (PCI) and coronary artery bypass grafting surgery. Some of these patients are poor surgical candidates because of previous cardiac surgery or significant comorbidities. The recent approval and availability of percutaneous left ventricular assist devices has created an opportunity for the highest risk patients. This article reviews currently available mechanical circulatory support systems and portable extracorporeal oxygenation, describing hemodynamic and physiologic rationales, indications, strategies, and available evidence for their use in high risk PCI.
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Romero-Bermejo FJ, Ruiz-Bailen M, Gil-Cebrian J, Huertos-Ranchal MJ. Sepsis-induced cardiomyopathy. Curr Cardiol Rev 2013; 7:163-83. [PMID: 22758615 PMCID: PMC3263481 DOI: 10.2174/157340311798220494] [Citation(s) in RCA: 188] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2011] [Revised: 02/24/2011] [Accepted: 02/24/2011] [Indexed: 01/20/2023] Open
Abstract
Myocardial dysfunction is one of the main predictors of poor outcome in septic patients, with mortality rates next to 70%. During the sepsis-induced myocardial dysfunction, both ventricles can dilate and diminish its ejection fraction, having less response to fluid resuscitation and catecholamines, but typically is assumed to be reversible within 7-10 days. In the last 30 years, It´s being subject of substantial research; however no explanation of its etiopathogenesis or effective treatment have been proved yet. The aim of this manuscript is to review on the most relevant aspects of the sepsis-induced myocardial dysfunction, discuss its clinical presentation, pathophysiology, etiopathogenesis, diagnostic tools and therapeutic strategies proposed in recent years.
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Affiliation(s)
- Francisco J Romero-Bermejo
- Intensive Care Unit, Critical Care and Emergency Department, Puerto Real University Hospital, Cadiz, Spain.
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7
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Using the Impella 5.0 with a Right Axillary Artery Approach as Bridge to Long-Term Mechanical Circulatory Assistance. Int J Artif Organs 2013; 36:605-11. [DOI: 10.5301/ijao.5000237] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2013] [Indexed: 11/20/2022]
Abstract
Purpose Impella 5.0 is a short-term left ventricle assist device (LVAD), inserted retrograde into the left ventricle across the aortic valve through a surgical peripheral access. Impella has been utilized for various indications but in the setting of bridge-to-bridge application there are limited reports. Methods We performed a retrospective observational analysis of Impella utilization at our institution as bridge to long-term LVADs. The primary end-point was survival during Impella support. Results Between December 2010 and February 2012, we implanted 20 Impella in patients with cardiogenic shock and, among these, 5 were implanted as bridge to long-term LVADs. In this latter group, mean age at the time of implantation was 44 ∓ 15.6 (range 27-68) years and there was a prevalence of males (80%). Etiology of cardiogenic shock was: decompensated anthracycline-induced cardiomyopathy (n = 1), myocardial infarction (n = 4). There was no major bleeding requiring surgical revision or infectious complications at the right axillary access. One patient required Impella replacement due to a pump stop. After a mean period of 14.2 ∓ 9.0 (range 6-27) days of Impella support, patients were switched to a long-term LVAD (Jarvik 2000, n = 2; HeartMate II, n = 3). One patient died 70 days after implantation of the long-term LVAD due to multi-organ failure, while the remaining patients are still alive after a mean period of follow-up of 108.6 ∓ 66.2 (range 19-191) days. Conclusions Our experience shows that an Impella 5.0 implanted through the right axillary artery approach is a valid option as bridge to long-term LVADs.
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Griffith BP, Anderson MB, Samuels LE, Pae WE, Naka Y, Frazier OH. The RECOVER I: A multicenter prospective study of Impella 5.0/LD for postcardiotomy circulatory support. J Thorac Cardiovasc Surg 2013; 145:548-54. [DOI: 10.1016/j.jtcvs.2012.01.067] [Citation(s) in RCA: 154] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Revised: 12/30/2011] [Accepted: 01/24/2012] [Indexed: 11/15/2022]
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Oses P, Casassus F, Leroux L, Calderon J, Barandon L. Optimization of Impella 5.0 implantation using mini-sternotomy approach in postmyocardial infarction cardiogenic shock. J Card Surg 2012; 27:605-6. [PMID: 22978837 DOI: 10.1111/j.1540-8191.2012.01507.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The Impella Recover LP 5.0® (Abiomed, Inc. Danvers, MA, USA) is an aortic transvalvular microaxial pump designed to unload the left ventricle and to ensure a systemic flow in severe left ventricular dysfunction. Surgical implantation using femoral or right subclavian approach may be difficult in certain circumstances, such as encountered in peripheral vascular disease, patients with small vessels or during substantial use of vasoactive drugs responsible for vasospasm. We propose a simple and effective technique for implantation of the Impella 5.0 LVAD by means of a mini-sternotomy in patients with postinfarction refractory cardiogenic shock.
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Affiliation(s)
- Pierre Oses
- CHU de Bordeaux, service de chirurgie cardiaque, Pessac, Bordeaux, France
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10
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Chandola R, Cusimano R, Osten M, Horlick E. Severe Aortic Insufficiency Secondary to 5L Impella Device Placement. J Card Surg 2012; 27:400-2. [DOI: 10.1111/j.1540-8191.2012.01454.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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11
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Yoshitake I, Hata M, Sezai A, Unosawa S, Wakui S, Kimura H, Nakata KI, Hata H, Shiono M. The effect of combined treatment with Impella(®) and landiolol in a swine model of acute myocardial infarction. J Artif Organs 2012; 15:231-9. [PMID: 22527977 DOI: 10.1007/s10047-012-0640-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Accepted: 03/15/2012] [Indexed: 10/28/2022]
Abstract
Cardiogenic shock is associated with a high mortality rate in patients with acute myocardial infarction (AMI). We developed a new treatment approach named heart rest therapy (HRT) for complete revascularization in the early stage of AMI using an ultra-short-acting β-blocker (landiolol) and an Impella(®) left ventricular assist device and verified the effect of this therapy in a swine model. In 18 male pigs, AMI was induced by left anterior descending coronary artery occlusion at the level of the second diagonal branch for 120 min, followed by 240 min of reperfusion. The animals were divided into three groups: group A had no support, group B was supported with the Impella(®), and group C was treated with HRT from 90 min after ischemia to 240 min after reperfusion. Infarct ratio (percentage of the infarct area relative to the area at infarct risk) was significantly reduced in group C (group A 65.38 ± 6.07, group B 39.66 ± 11.16, group C 21.78 ± 7.29), with a significant difference between groups A and B (P < 0.001), A and C (P < 0.001), and B and C (P = 0.006). Heart rates were significantly lower in group C at 30 min (P = 0.01), 60 min (P = 0.022), and 240 min (P = 0.032) after reperfusion compared with group B, without development of hypotension. HRT at the early stage in AMI stabilized the hemodynamic conditions and reduced infarct size and complications in a swine model. These results suggest that HRT can improve the prognosis of patients with AMI.
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Affiliation(s)
- Isamu Yoshitake
- Department of Cardiovascular Surgery, Nihon University School of Medicine, Ohyaguchi kami-machi 30-1, Itabashi-ku, Tokyo 173-8610, Japan.
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12
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Severe heart failure and mechanical circulatory support. Int Anesthesiol Clin 2012; 50:1-15. [PMID: 22481553 DOI: 10.1097/aia.0b013e31825095b9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Dual percutaneous mechanical circulatory support as a bridge to recovery in fulminant myocarditis. ASAIO J 2012; 57:477-9. [PMID: 21817895 DOI: 10.1097/mat.0b013e31822bbcab] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Brown C, Joshi B, Faraday N, Shah A, Yuh D, Rade JJ, Hogue CW. Emergency cardiac surgery in patients with acute coronary syndromes: a review of the evidence and perioperative implications of medical and mechanical therapeutics. Anesth Analg 2011; 112:777-99. [PMID: 21385977 DOI: 10.1213/ane.0b013e31820e7e4f] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Patients with acute coronary syndromes who require emergency cardiac surgery present complex management challenges. The early administration of antiplatelet and antithrombotic drugs has improved overall survival for patients with acute myocardial infarction, but to achieve maximal benefit, these drugs are given before coronary anatomy is known and before the decision to perform percutaneous coronary interventions or surgical revascularization has been made. A major bleeding event secondary to these drugs is associated with a high rate of death in medically treated patients with acute coronary syndrome possibly because of subsequent withholding of antiplatelet and antithrombotic therapies that otherwise reduce the rate of death, stroke, or recurrent myocardial infarction. Whether the added risk of bleeding and blood transfusion in cardiac surgical patients receiving such potent antiplatelet or antithrombotic therapy before surgery specifically for acute coronary syndromes affects long-term mortality has not been clearly established. For patients who do proceed to surgery, strategies to minimize bleeding include stopping the anticoagulation therapy and considering platelet and/or coagulation factor transfusion and possibly recombinant-activated factor VIIa administration for refractory bleeding. Mechanical hemodynamic support has emerged as an important option for patients with acute coronary syndromes in cardiogenic shock. For these patients, perioperative considerations include maintaining appropriate anticoagulation, ensuring suitable device flow, and periodically verifying correct device placement. Data supporting the use of these devices are derived from small trials that did not address long-term postoperative outcomes. Future directions of research will seek to optimize the balance between reducing myocardial ischemic risk with antiplatelet and antithrombotics versus the higher rate perioperative bleeding by better risk stratifying surgical candidates and by assessing the effectiveness of newer reversible drugs. The effects of mechanical hemodynamic support on long-term patient outcomes need more stringent analysis.
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Affiliation(s)
- Charles Brown
- Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Rasalingam R, Johnson SN, Bilhorn KR, Huang PH, Makan M, Moazami N, Pérez JE. Transthoracic Echocardiographic Assessment of Continuous-Flow Left Ventricular Assist Devices. J Am Soc Echocardiogr 2011; 24:135-48. [DOI: 10.1016/j.echo.2010.11.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Indexed: 10/18/2022]
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Patel CB, Alexander KM, Rogers JG. Mechanical Circulatory Support for Advanced Heart Failure. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2010; 12:549-65. [DOI: 10.1007/s11936-010-0093-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bashir J, Klas M, Cheung A. Peripheral Insertion Techniques for the Impella 5.0 Circulatory Support System. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2010. [DOI: 10.1177/155698451000500506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jamil Bashir
- Division of Cardiovascular Surgery, University of British Columbia, St. Paul's Hospital, Vancouver, BC Canada
| | - Matt Klas
- Department of Anesthesia, University of British Columbia, St. Paul's Hospital, Vancouver, BC Canada
| | - Anson Cheung
- Division of Cardiovascular Surgery, University of British Columbia, St. Paul's Hospital, Vancouver, BC Canada
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Peripheral insertion techniques for the Impella 5.0 circulatory support system. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2010; 5:341-4. [PMID: 22437518 DOI: 10.1097/imi.0b013e3181f8b79d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The Impella 5.0 is a peripherally inserted short-term left ventricular assist device. It is typically inserted through a large peripheral artery such as the common femoral artery. We describe both a graft technique and a purse-string technique in detail. METHODS In the course of introducing this technology to our hospital, we independently developed two techniques for the insertion of the device. These novel insertion techniques are different from those described by the manufacturer. RESULTS The techniques described have distinct advantages that may be helpful to physicians inserting the device. Common areas of difficulty with insertion of the device and solutions to these problems are also described. CONCLUSIONS Insertion techniques for the Impella 5.0 are described in detail.
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Pulido JN, Park SJ, Rihal CS. Percutaneous Left Ventricular Assist Devices: Clinical Uses, Future Applications, and Anesthetic Considerations. J Cardiothorac Vasc Anesth 2010; 24:478-86. [DOI: 10.1053/j.jvca.2009.10.026] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2009] [Indexed: 11/11/2022]
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Abstract
The mortality of acute heart failure (AHF) remains high despite advances in treatment. Mechanical circulatory support (MCS) can be applied in AHF, refractory to conventional measures, to improve outcomes. This article aims to describe the current and the prospective role of MCS in the treatment of AHF. The support strategies and the indications of MCS are continuously evolving, including situations considered as contraindications in the past. Appropriate patient selection, advanced device technology and improved patient management have contributed to the substantially improved results. Evolution in device technology results in evolution of the clinical applications of MCS. Earlier application of MCS, with novel, flexible and individualized support strategies is now feasible. Bridging to recovery is the most intriguing support strategy and bridging to future treatments is feasible with long-term support. The progressively expanding role of MCS in the treatment of heart failure is not reflected in the existing guidelines. Being reserved for refractory heart failure, MCS has been applied to the sickest patients who were less amenable to randomization. This explains the lack of robust evidence, but also highlights the value of the progressively improving results. The anticipated wider application of MCS should be better defined, systematically recorded, and guided.
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Affiliation(s)
- Antonis A Pitsis
- Thessaloniki Heart Institute, St Luke's Hospital-Cardiac Surgery, Thessaloniki, Greece.
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21
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Sylvin EA, Stern DR, Goldstein DJ. Mechanical Support for Postcardiotomy Cardiogenic Shock: Has Progress Been Made? J Card Surg 2010; 25:442-54. [DOI: 10.1111/j.1540-8191.2010.01045.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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22
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Granfeldt H, Hellgren L, Dellgren G, Myrdal G, Wassberg E, Kjellman U, Ahn H. Experience with the Impella® recovery axial-flow system for acute heart failure at three cardiothoracic centers in Sweden. SCAND CARDIOVASC J 2009; 43:233-9. [DOI: 10.1080/14017430802715954] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hermansen SE, Næsheim T, How OJ, Myrmel T. Circulatory assistance in acute heart failure – where do we go from here? SCAND CARDIOVASC J 2009; 43:211-6. [DOI: 10.1080/14017430802715962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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24
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Smith EJ, Reitan O, Keeble T, Dixon K, Rothman MT. A first-in-man study of the reitan catheter pump for circulatory support in patients undergoing high-risk percutaneous coronary intervention. Catheter Cardiovasc Interv 2009; 73:859-65. [DOI: 10.1002/ccd.21865] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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25
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Jara-Rubio R, Fernández-Vivas M, Royo-Villanova M, Llamas-Lázaro C, Torres-Martínez G, Arcas-Meca R. Experiencia preliminar en una unidad de cuidados intensivos con Impella Recover®. Asistencia ventricular microaxial en pacientes con bajo gasto cardíaco. Med Intensiva 2009; 33:207-10. [DOI: 10.1016/s0210-5691(09)71217-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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26
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A combined surgical and percutaneous approach through the axillary artery to introduce the Impella LP5.0 for short-term circulatory support. Int J Cardiol 2009; 134:277-9. [DOI: 10.1016/j.ijcard.2007.12.112] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2007] [Accepted: 12/15/2007] [Indexed: 11/22/2022]
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27
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Techniques and Complications of TandemHeart Ventricular Assist Device Insertion During Cardiac Procedures. ASAIO J 2009; 55:251-4. [DOI: 10.1097/mat.0b013e31819644b3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Percutaneous Impella Recover circulatory support in high-risk coronary angioplasty. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2008; 9:269-74. [DOI: 10.1016/j.carrev.2008.04.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2008] [Accepted: 04/30/2008] [Indexed: 11/20/2022]
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Rossiter-Thornton M, Arun V, Forrest AP, Bayfield MS, Wilson MK. Left Ventricular Support with the Impella® LP 5.0 for Cardiogenic Shock Following Cardiac Surgery. Heart Lung Circ 2008; 17:243-5. [DOI: 10.1016/j.hlc.2008.02.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2007] [Revised: 01/30/2008] [Accepted: 02/09/2008] [Indexed: 10/22/2022]
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Sassard T, Scalabre A, Bonnefoy E, Sanchez I, Farhat F, Jegaden O. The Right Axillary Artery Approach for the Impella Recover LP 5.0 Microaxial Pump. Ann Thorac Surg 2008; 85:1468-70. [DOI: 10.1016/j.athoracsur.2007.09.017] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2007] [Revised: 08/31/2007] [Accepted: 09/11/2007] [Indexed: 11/28/2022]
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Malchesky PS. Artificial Organs 2006: a year in review. Artif Organs 2007; 31:225-41. [PMID: 17343699 DOI: 10.1111/j.1525-1594.2007.00370.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Paul S Malchesky
- Artificial Organs Editorial Office, 10 West Erie Street, Painesville, OH 44077, USA.
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