13,617 results match your criteria Cardiogenic Shock


Ablation of atrial arrhythmias in patients with cardiogenic shock on mechanical circulatory support.

HeartRhythm Case Rep 2019 Mar 28;5(3):115-119. Epub 2018 Nov 28.

Division of Cardiology, Section of Electrophysiology, University of Colorado, Denver, Aurora, Colorado.

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http://dx.doi.org/10.1016/j.hrcr.2018.11.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6404096PMC

Ischemic posterior wall cardiac rupture: early intervention is key for success.

Asian Cardiovasc Thorac Ann 2019 Mar 19:218492319839573. Epub 2019 Mar 19.

Department of Cardiothoracic Surgery, Dubai Hospital, Dubai Health Authority, Dubai, United Arab Emirates.

Posterior left ventricular free wall rupture is rare, difficult to diagnose, and potentially fatal secondary to tamponade. The optimal surgical technique is controversial, and the outcome depends on the severity of the rupture. A 51-year-old man with acute myocardial infarction complicated by posterior wall rupture presented in extremis with retrosternal pain. Read More

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http://dx.doi.org/10.1177/0218492319839573DOI Listing

Selenoprotein P in Myocardial Infarction with Cardiogenic Shock.

Shock 2019 Mar 14. Epub 2019 Mar 14.

Heart Center Leipzig at University of Leipzig, Department of Internal Medicine/Cardiology, Leipzig, Germany.

Background: Reperfusion strategies in acute myocardial infarction (AMI) may result in ischemia reperfusion injury characterized by increased oxidative stress, inflammation and ultimately death of myocardial tissue which may be of particular importance in infarct-related cardiogenic shock (CS). Many anti-oxidative and immune regulatory processes depend on selenium which in large proportions is bound to circulating selenoprotein P (SelP). Individual SelP patterns may therefore be associated with inflammatory response and possibly mortality in patients with CS post AMI. Read More

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http://dx.doi.org/10.1097/SHK.0000000000001342DOI Listing

Use of the brief Confusion Assessment Method in a veteran palliative care population: A pilot validation study.

Palliat Support Care 2019 Mar 19:1-5. Epub 2019 Mar 19.

Geriatric Research, Education and Clinical Center,Veterans Affairs TN Valley.

Objective: Many patients with advanced serious illness or at the end of life experience delirium, a potentially reversible form of acute brain dysfunction, which may impair ability to participate in medical decision-making and to engage with their loved ones. Screening for delirium provides an opportunity to address modifiable causes. Unfortunately, delirium remains underrecognized. Read More

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http://dx.doi.org/10.1017/S1478951518001050DOI Listing

Critical Hemodynamic Therapy-oriented resuscitation helping reduce lung water production and improve survival.

Chin Med J (Engl) 2019 Mar 13. Epub 2019 Mar 13.

Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China.

Backgrounds: Increased extravascular lung water in shock is common in the critically ill patients. This study aimed to explore the effect of cardiac output (CO) on extravascular lung water (EVLW) and its relevant influence on prognosis.

Methods: The hemodynamic data of 428 patients with pulse indicated continuous cardiac output (PICCO) catheterization from Department of Critical Care Medicine, Peking Union Medical College Hospital were retrospectively collected and analyzed. Read More

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http://dx.doi.org/10.1097/CM9.0000000000000205DOI Listing

Axillary Artery Access for Mechanical Circulatory Support Devices in Patients With Prohibitive Peripheral Arterial Disease Presenting With Cardiogenic Shock.

Am J Cardiol 2019 Feb 27. Epub 2019 Feb 27.

Wayne State University School of Medicine, Detroit Medical Center, Detroit, Michigan.

In patients with severe peripheral vascular disease, the common femoral artery may be so diseased as to not allow for deployment of mechanical circulatory support (MCS) such as in the setting of cardiogenic shock (CS). We sought to study the feasibility of axillary artery as alternative access for MCS in CS patients with severe occlusive peripheral artery disease (PAD). Records of all patients who presented with CS requiring MCS through axillary artery access from January 2016 to October 2017 were examined. Read More

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http://dx.doi.org/10.1016/j.amjcard.2019.02.033DOI Listing
February 2019

Epidemiology of Shock in Contemporary Cardiac Intensive Care Units.

Circ Cardiovasc Qual Outcomes 2019 Mar;12(3):e005618

Levine Cardiac Intensive Care Unit, TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (D.D.B, E.A.B., V.M.B.-Z., J.-G.P., D.A.M.).

Background Clinical investigations of shock in cardiac intensive care units (CICUs) have primarily focused on acute myocardial infarction (AMI) complicated by cardiogenic shock (AMICS). Few studies have evaluated the full spectrum of shock in contemporary CICUs. Methods and Results The Critical Care Cardiology Trials Network is a multicenter network of advanced CICUs in North America. Read More

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http://dx.doi.org/10.1161/CIRCOUTCOMES.119.005618DOI Listing

Cannula position and Bernoulli effect contribute to leg malperfusion during extracorporeal life support with femoral arterial cannulation-an in silico simulation study†.

Interact Cardiovasc Thorac Surg 2019 Mar 15. Epub 2019 Mar 15.

Department of Adult and Pediatric Cardiovascular Surgery, Giessen University Hospital, Giessen, Germany.

Objectives: Limb ischaemia during extracorporeal life support (ECLS) using femoral artery cannulation is frequently observed even in patients with regular vessel diameters and without peripheral arterial occlusive disease. We investigated underlying pathomechanisms using a virtual fluid-mechanical simulation of the human circulation.

Methods: A life-sized model of the human aorta and major vascular branches was virtualized using 3-dimensional segmentation software (Mimics, Materialise). Read More

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http://dx.doi.org/10.1093/icvts/ivz048DOI Listing
March 2019
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Intravascular Ultrasound for Complex Percutaneous Coronary Intervention: A Far Too Complex Way to Recognition.

JACC Cardiovasc Interv 2019 Mar 9. Epub 2019 Mar 9.

Hospital Universitario Marques de Valdecilla, Servicio de Cardiología, Unidad de Cardiología Intervencionista, IDIVAL, Santander, Spain. Electronic address:

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http://dx.doi.org/10.1016/j.jcin.2019.01.236DOI Listing

Trans-aortic left ventricular unloading in VA-ECMO: the trans-subclavian route.

Ann Thorac Surg 2019 Mar 13. Epub 2019 Mar 13.

Cardiac surgery department, CHU Clermont-Ferrand, France.

Left ventricular unloading (LVU) during extracorporeal life support aims to minimize potential side effects of increased left ventricular afterload. A transaortic catheter vent implanted through a subclavian approach was used in two patients. Case 1 was a 48-year-old male with a recent history of STEMI, who developed refractory cardiogenic shock due to severe biventricular dysfunction. Read More

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http://dx.doi.org/10.1016/j.athoracsur.2019.01.080DOI Listing

Management of Anticoagulation with Impella® Percutaneous Ventricular Assist Devices and Review of New Literature.

J Thromb Thrombolysis 2019 Mar 15. Epub 2019 Mar 15.

Department of Pharmacy, Houston Methodist Hospital, Houston, TX, USA.

Cardiogenic shock is a life-threatening condition that may occur secondary to a variety of cardiac conditions, and may require temporary support with percutaneous ventricular devices like the Impella®. Anticoagulation in patients with Impella® devices can often be complicated due to unpredictable purge flow rates, pre-existing coagulopathy, or heparin allergies. The purpose of this article is to discuss the various options for anticoagulation in the setting of Impella®. Read More

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http://dx.doi.org/10.1007/s11239-019-01837-6DOI Listing
March 2019
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Bolus Dose Epinephrine improves blood pressure but is associated with increased mortality in critical care transport.

Prehosp Emerg Care 2019 Mar 15:1-11. Epub 2019 Mar 15.

f University of Pittsburgh Department of Emergency Medicine , 3600 Forbes Ave., Suite 400A , Pittsburgh , 15260 United States.

Introduction: Hypotension in the prehospital environment is common and linked to dose-dependent mortality. Bolus dose epinephrine (BDE) may reverse hypotension. We tested if BDE use to treat profound hypotension is associated with 24-hour survival. Read More

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https://www.tandfonline.com/doi/full/10.1080/10903127.2019.1
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http://dx.doi.org/10.1080/10903127.2019.1593564DOI Listing
March 2019
10 Reads

Temporal trends and outcomes of prolonged invasive mechanical ventilation and tracheostomy use in acute myocardial infarction with cardiogenic shock in the United States.

Int J Cardiol 2019 Mar 6. Epub 2019 Mar 6.

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States of America.

Background: There are limited data on prolonged invasive mechanical ventilation (IMV) and tracheostomy use in intubated acute myocardial infarction with cardiogenic shock (AMI-CS) patients.

Methods: Using the National Inpatient Sample, all admissions with AMI-CS requiring IMV between January 1, 2000, and December 31, 2014, were included. Prolonged IMV was defined as IMV use >96 h. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S01675273183717
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http://dx.doi.org/10.1016/j.ijcard.2019.03.008DOI Listing
March 2019
1 Read
4.036 Impact Factor

[Shock. Main etiologies: hypovolemic, septic, cardiogenic, anaphylactic].

Rev Prat 2018 Oct;68(8):e321-e326

AP-HP, Hôpitaux universitaires Henri-Mondor, DHU A-TVB, service de réanimation médicale, 94010 Créteil, France Université Paris-Est-Créteil, faculté de médecine, IMRB, groupe de recherche CARMAS 94010 Créteil, France.

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October 2018
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Continuous monitoring of membrane lung carbon dioxide removal during ECMO: experimental testing of a new volumetric capnometer.

Perfusion 2019 Mar 14:267659119833233. Epub 2019 Mar 14.

1 Cardio-Thoracic Surgery Department, Heart+Vascular Centre, Maastricht University Medical Center, Maastricht, The Netherlands.

Background:: Extracorporeal membrane oxygenation constitutes a complex support modality, and accurate monitoring is required. An ideal monitoring system should promptly detect ECMO malfunctions and provide real-time information to optimize the patient-machine interactions. We tested a new volumetric capnometer which enables continuous monitoring of membrane lung carbon dioxide removal (V'COML), to help in estimating the oxygenator performance, in terms of CO removal and oxygenator dead space (VDsML). Read More

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http://dx.doi.org/10.1177/0267659119833233DOI Listing
March 2019
2 Reads

Cardiac Assist Devices in Cardiogenic Shock.

Circulation 2019 Mar;139(10):1259-1261

Department of Cardiology, European Hospital Geroges Pompidou, Assistance Publique Hôpitaux de Paris, Paris Descartes University, France (E.P.,C.S.).

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http://dx.doi.org/10.1161/CIRCULATIONAHA.118.038855DOI Listing
March 2019
1 Read

Predictors of in-hospital and long-term mortality in unselected patients admitted to a modern coronary care unit.

J Cardiovasc Med (Hagerstown) 2019 Mar 8. Epub 2019 Mar 8.

Cardiology Department, Santa Maria della Misericordia Hospital.

Aims: Objective data on epidemiology, management and outcome of patients with acute cardiac illness are still scarce, and producing evidence-based guidelines remains an issue. In order to define the clinical characteristics and the potential predictors of in-hospital and long-term mortality, we performed a retrospective, observational study, in a tertiary cardiac centre in Italy.

Methods: One thousand one hundred and sixty-five consecutive patients, admitted to our intensive cardiac care unit (ICCU) during the year 2016, were included in the study. Read More

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http://dx.doi.org/10.2459/JCM.0000000000000785DOI Listing
March 2019
1 Read

Prognostic Factors for Survival After Extracorporeal Membrane Oxygenation for Cardiogenic Shock.

ASAIO J 2019 Mar 6. Epub 2019 Mar 6.

From the National Heart Centre Singapore, 5 Hospital Drive, Singapore 169609, Singapore.

The aim of this study is to examine factors that can predict mortality in patients that have veno-arterial extracorporeal membrane oxygenation (VA-ECMO) instituted for cardiogenic shock. A single-center, retrospective study of 127 patients who underwent VA-ECMO for cardiogenic shock between January 2003 and December 2017 was conducted. Eighty-three (65%) patients survived to weaning or bridging therapy. Read More

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http://dx.doi.org/10.1097/MAT.0000000000000984DOI Listing
March 2019
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Venoarterial Extracorporeal Membrane Oxygenation as Supportive Therapy After Cardiac Arrest After Amniotic Fluid Embolism: A Case Report.

A A Pract 2019 Mar 6. Epub 2019 Mar 6.

From the Departments of Anesthesiology and Surgical Intensive Care.

Amniotic fluid embolism is a rare but dreaded complication of pregnancy, with an incidence between 2 and 7/100,000 deliveries. We report an amniotic fluid embolism after urgent cesarean delivery diagnosed on a cardiac arrest, complicated by cardiogenic shock and acute respiratory distress syndrome. This report describes the indication, efficacy, and success of venoarterial extracorporeal membrane oxygenation in the early management of cardiac arrest, cardiac failure driven by amniotic fluid embolism, and acute respiratory distress syndrome. Read More

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http://dx.doi.org/10.1213/XAA.0000000000000995DOI Listing
March 2019
3 Reads

Clinical presentation and early predictors for poor outcomes in pediatric myocarditis: A retrospective study.

World J Clin Cases 2019 Mar;7(5):548-561

Department of Pediatric Nephrology, Puerta del Mar University Hospital, Cadiz 11009, Spain.

Background: Myocarditis is an important cause of morbidity and mortality in children, leading to long-term sequelae including chronic congestive heart failure, dilated cardiomyopathy, heart transplantation, and death. The initial diagnosis of myocarditis is usually based on clinical presentation, but this widely ranges from the severe sudden onset of a cardiogenic shock to asymptomatic patients. Early recognition is essential in order to monitor and start supportive treatment prior to the development of severe adverse events. Read More

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https://www.wjgnet.com/2307-8960/full/v7/i5/548.htm
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http://dx.doi.org/10.12998/wjcc.v7.i5.548DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406197PMC
March 2019
1 Read

Clinical implications of the initial SAPS II in veno-arterial extracorporeal oxygenation.

J Thorac Dis 2019 Jan;11(1):68-83

Department of Thoracic and Cardiovascular Surgery, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju-si, Chungbuk, Republic of Korea.

Background: Prediction of survival and weaning probability in VA ECMO (veno-arterial extracorporeal membrane oxygenation) patients could be of great benefit for real-time decision making on VA ECMO initiation in critical ill patients. We investigated whether the SAPS II score would be a real-time determinant for VA ECMO initiation and could be a predictor of survival and weaning probability in patients on VA ECMO.

Methods: Between January 1, 2010 and December 31, 2014, VA ECMO was carried out on 135 adult patients suffering from primary cardiogenic shock. Read More

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http://jtd.amegroups.com/article/view/26062/19813
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http://dx.doi.org/10.21037/jtd.2018.12.20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6384379PMC
January 2019
2 Reads

Haemodynamic simulation and the effect of early left ventricular unloading in pre-shock acute coronary syndrome.

ESC Heart Fail 2019 Mar 12. Epub 2019 Mar 12.

Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625, Hannover, Germany.

Aims: Understanding the pathophysiological background on haemodynamic changes in acute myocardial infarction and during its interventional treatment is important to adequately use mechanical circulatory support.

Methods And Results: We describe haemodynamic simulations based on a real case scenario of infarct-related ischaemia with beginning haemodynamic compromise illustrating the advantage of active haemodynamic support. The patient case used for computer simulation is that of an acute coronary syndrome, slightly hypotonic. Read More

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http://doi.wiley.com/10.1002/ehf2.12417
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http://dx.doi.org/10.1002/ehf2.12417DOI Listing
March 2019
5 Reads

Thrombus aspiration in patients with ST-elevation myocardial infarction presenting late after symptom onset: long-term clinical outcome of a randomized trial.

Clin Res Cardiol 2019 Mar 11. Epub 2019 Mar 11.

Department of Internal Medicine/Cardiology, Heart Center Leipzig at University of Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany.

Background: In the largest randomized trial so far, thrombus aspiration failed to reduce the primary endpoint of microvascular obstruction (MVO) in patients with ST-elevation myocardial infarction (STEMI) presenting late after symptom onset. Long-term clinical outcome data of this trial have not been reported yet.

Methods And Results: A total of 144 patients with STEMI presenting ≥ 12 and ≤ 48 h after symptom onset were randomized to primary percutaneous coronary intervention (PCI) with or without manual thrombus aspiration in a 1:1 fashion. Read More

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http://dx.doi.org/10.1007/s00392-019-01452-8DOI Listing

Triple bridge of mechanical circulatory support to heart transplantation listing: A case report.

SAGE Open Med Case Rep 2019 5;7:2050313X19834816. Epub 2019 Mar 5.

Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, FL, USA.

A 60-year-old male patient presented to an outside hospital with severe cardiogenic shock. A triple bridge of mechanical circulatory support was utilized to transition him to heart transplantation listing. Initially, coronary artery disease was percutaneously treated and Impella 2. Read More

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http://journals.sagepub.com/doi/10.1177/2050313X19834816
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http://dx.doi.org/10.1177/2050313X19834816DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6404238PMC
March 2019
1 Read

Successful Re-Initiation of Therapeutic Hypothermia as Adjunctive Salvage Therapy in a Case of Refractory Cardiogenic Shock Due to Acute Myocardial Infarction.

Am J Case Rep 2019 Mar 12;20:323-329. Epub 2019 Mar 12.

Permian Research Fundation, Odessa, TX, USA.

BACKGROUND Acute myocardial infarction (AMI) complicated by cardiogenic shock has a high mortality rate, despite prompt revascularization, advanced medical therapy and the use of mechanical circulatory support devices. Therapeutic hypothermia is associated with physiological cellular changes in the ischemic myocardium, and a trend towards improved hemodynamics in patients with AMI and cardiogenic shock, but is currently not considered to be a therapeutic modality. A case is presented that supports the role of therapeutic hypothermia as salvage therapy in patients with cardiogenic shock following AMI. Read More

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http://dx.doi.org/10.12659/AJCR.913459DOI Listing
March 2019
2 Reads

Trends in Utilization and Outcomes of Pulmonary Artery Catheterization in Heart Failure With and Without Cardiogenic Shock.

J Card Fail 2019 Mar 8. Epub 2019 Mar 8.

Division of Advanced Heart Failure and Transplant Cardiology, Vanderbilt University Medical Center, Nashville, TN.

Background: The pulmonary artery catheter (PAC) has been used in a wide-range of critically ill patients. It is not indicated for routine care of heart failure (HF) but its role in cardiogenic shock (CS) has not been clarified.

Methods And Results: We conducted a retrospective cohort study using the National Inpatient Sample and identified a total of 9,431,944 adult patients between 2004 and 2014 admitted with the primary diagnosis of HF (n=8,516,528) or who developed CS (n= 915,416) during the index hospitalization. Read More

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http://dx.doi.org/10.1016/j.cardfail.2019.03.004DOI Listing

Impact of extra-corporeal membrane oxygenation on outcome of aluminium phosphide poisoning complicated with myocardial dysfunction.

Clin Toxicol (Phila) 2019 Mar 11:1-8. Epub 2019 Mar 11.

a Department of Cardiology , Dayanand Medical College and Hospital , Ludhiana , India.

Background: Aluminium phosphide (AlP) poisoning is associated with a high mortality rate when patients are complicated with myocardial dysfunction and refractory shock or severe metabolic acidosis. We studied the role of veno-arterial extra-corporeal membrane oxygenation (VA-ECMO) in patients of AlP poisoning induced myocardial dysfunction.

Methods And Results: This is a tertiary care, single-centre, retrospective study. Read More

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http://dx.doi.org/10.1080/15563650.2019.1584297DOI Listing
March 2019
2 Reads

Weaning from veno-arterial extra-corporeal membrane oxygenation: which strategy to use?

Ann Cardiothorac Surg 2019 Jan;8(1):E1-E8

Department of Intensive Care Cnit, Hôpital Européen Georges Pompidou (HEGP) Assistance Publique-Hôpitaux de Paris (APHP) and Université Paris Descartes, Paris, France.

Refractory cardiogenic shock patients may be rescued by veno-arterial extracorporeal membrane oxygenation (VA ECMO). After a few days of mechanical assistance, the device can sometimes be successfully removed if the patient has partially or fully recovered from the condition that required the use of ECMO. The percentage of patients with refractory cardiogenic shock who are successfully weaned from ECMO varies from 31% to 76%. Read More

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http://dx.doi.org/10.21037/acs.2018.08.05DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379199PMC
January 2019

Short-term mechanical circulatory support as bridge to heart transplantation: paracorporeal ventricular assist device as alternative to extracorporeal life support.

Ann Cardiothorac Surg 2019 Jan;8(1):143-150

Cardiothoracic Department, University Hospital of Udine, Udine, Italy.

Extracorporeal life support (ECLS) is generally considered to be the treatment of choice for bridging to heart transplantation (HTx) patients with cardiogenic shock; however, alternative mechanical circulatory support (MCS) devices have been proposed with satisfactory results and, among those, paracorporeal systems have demonstrated to be safe and effective. This technology has been used for decades as bridge to transplant, especially in patients with advanced right ventricular dysfunction or evidence of multiorgan failure (MOF), which could be difficult to manage with an isolated left ventricular support. Paracorporeal systems are defined by having the pump located outside of the body, with inflow and outflow cannulas that traverse the skin connecting the pump with the heart and great vessels. Read More

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http://dx.doi.org/10.21037/acs.2019.01.01DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379185PMC
January 2019
1 Read

Cardiac catheterization and percutaneous intervention procedures on extracorporeal membrane oxygenation support.

Ann Cardiothorac Surg 2019 Jan;8(1):123-128

Annette C. and Harold C. Simmons Transplant Institute, Baylor Scott & White Research Institute, Dallas, TX, USA.

Extracorporeal membrane oxygenation (ECMO) is used to support critically ill patients when conventional therapies have failed. ECMO has been available for four decades and has gained use as a rescue therapy in severe refractory hypoxic disorders and in patients with refractory cardiogenic shock (RCS). Over recent years, several percutaneous cardiac interventions and implant devices have been developed that are now used frequently in conjunction with ECMO in order to maintain organ perfusion. Read More

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http://dx.doi.org/10.21037/acs.2018.11.08DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379180PMC
January 2019
1 Read

Long-term survival and major outcomes in post-cardiotomy extracorporeal membrane oxygenation for adult patients in cardiogenic shock.

Ann Cardiothorac Surg 2019 Jan;8(1):116-122

Department of Cardio-Thoracic Surgery, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.

Extracorporeal membrane oxygenation (ECMO) in the veno-arterial (VA) configuration is an established method for the treatment of refractory cardiogenic shock. Such a condition characterizes the postoperative course of approximatively 1% of cardiac surgery patients. Although some studies have reported ECMO-related short-term results, little is known about the long-term outcomes of VA-ECMO therapy in the post-cardiotomy setting. Read More

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http://dx.doi.org/10.21037/acs.2018.12.04DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379181PMC
January 2019
1 Read

Temporary mechanical circulatory support for refractory heart failure: the German Heart Center Berlin experience.

Ann Cardiothorac Surg 2019 Jan;8(1):76-83

Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.

Background: Temporary mechanical circulatory support (MCS) offers a valuable option for treatment of refractory heart failure. We present our experience with selected MCS devices in cardiogenic shock of different etiologies.

Methods: We retrospectively studied patients who were treated in our institution between 01/2016 and 07/2018. Read More

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http://dx.doi.org/10.21037/acs.2018.12.01DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379195PMC
January 2019
1 Read

Adult cardiac veno-arterial extracorporeal life support (VA-ECMO): prevention and management of acute complications.

Ann Cardiothorac Surg 2019 Jan;8(1):66-75

Advanced Cardiac Care and Transplant Institute, Integris Baptist Medical Center, Oklahoma City, OK, USA.

Background: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been shown to be a viable and effective treatment for patients suffering from refractory cardiogenic shock (rCS), which is associated with high mortality rates. Although ECMO therapy used as short-term mechanical circulatory support (MCS) has shown tremendous growth in its application over the past decade, the complication and mortality rates remain high. This retrospective study analyzes complications associated with VA-ECMO support, evaluates the use of defined protocols at a single center, and examines factors that may contribute to patient complication and mortality. Read More

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http://dx.doi.org/10.21037/acs.2018.12.09DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379202PMC
January 2019
1 Read

Inter-hospital transfer of extracorporeal membrane oxygenation-assisted patients: the hub and spoke network.

Ann Cardiothorac Surg 2019 Jan;8(1):62-65

Clinic for Thoracic- and Cardiovascular Surgery, Heart and Diabetes Centre North Rhine Westphalia, Bad Oeynhausen, Germany.

Background: The treatment of cardiogenic shock (CS) in peripheral hospitals may be challenging when acute mechanical circulatory support (MCS) is not available. Tertiary care centers may provide mobile extracorporeal membrane oxygenation (ECMO) teams to support the treatment of CS-patients externally.

Methods: We retrospectively analyzed our single-center experience with a mobile ECMO team focussing on decision-making and survival data of CS-patients retrieved by ECMO support from peripheral hospitals to our tertiary care center between January 2012 and October 2018. Read More

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http://dx.doi.org/10.21037/acs.2018.12.03DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379188PMC
January 2019
1 Read

Temporary support strategies for cardiogenic shock: extracorporeal membrane oxygenation, percutaneous ventricular assist devices and surgically placed extracorporeal ventricular assist devices.

Ann Cardiothorac Surg 2019 Jan;8(1):32-43

Division of Cardiac Surgery, Thomas Jefferson University, Philadelphia, PA, USA.

The majority of clinical pathways and paradigms utilized in the treatment and management of cardiogenic shock with temporary mechanical circulatory support (MCS) are largely based on individual physician intuition and ad hoc problem-solving. Substantial mortality gains in the acute myocardial infarction cardiogenic shock (AMI-CS) population were observed with the reported outcomes of the SHOCK trial in 1999 compared to previous populations with AMI-CS. Nonetheless even in the age of percutaneous coronary intervention (PCI) of the infarct related artery, survival rates continue to be only approximately 50%. Read More

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http://dx.doi.org/10.21037/acs.2018.11.05DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379194PMC
January 2019
1 Read

Left ventricular decompression in veno-arterial extracorporeal membrane oxygenation.

Ann Cardiothorac Surg 2019 Jan;8(1):9-18

Department of Cardiothoracic, Transplantation and Vascular Surgery, S. Orsola Hospital, Bologna University, Bologna, Italy.

Background: Despite the survival benefit of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for treatment of refractory cardiogenic shock, it can also have potentially deleterious effects of left ventricular overload and pulmonary edema. The objective of this review was to investigate the current evidence on the incidence, diagnosis, risk factors, prevention, and interventions for left ventricular overload in adult and pediatric VA-ECMO patients.

Methods: Five electronic databases, including MEDLINE, EMBASE, PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Cochrane Database of Systematic Reviews, were searched for original published studies from their dates of inception to January 2018. Read More

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http://dx.doi.org/10.21037/acs.2018.11.07DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379183PMC
January 2019
1 Read

Outcomes of venoarterial extracorporeal membrane oxygenation for refractory cardiogenic shock: systematic review and meta-analysis.

Ann Cardiothorac Surg 2019 Jan;8(1):1-8

Department of Cardiovascular Surgery and Transplantation, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.

Background: Despite advances in management techniques and medical therapy, refractory cardiogenic shock remains a life-threatening condition with high mortality rates. The present systematic review and meta-analysis aims to explore the outcomes associated with venoarterial extracorporeal membrane oxygenation (VA-ECMO) use in the setting of refractory cardiogenic shock, stratified per survivorship.

Methods: A literature search was performed using three electronic databases from the date of their inception up to June 2018. Read More

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http://dx.doi.org/10.21037/acs.2018.11.09DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379189PMC
January 2019
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Mid-term outcomes of bridge-to-recovery patients after short-term mechanical circulatory support.

Ann Thorac Surg 2019 Mar 6. Epub 2019 Mar 6.

Department of Surgery, Division of Cardiothoracic Surgery, Columbia University Medical Center, New York, NY. Electronic address:

Background: The use of short-term mechanical circulatory support (ST-MCS) has increased for refractory cardiogenic shock. However, there is little data about bridge-to-recovery patients.

Methods: We retrospectively reviewed 502 cardiogenic shock patients who received either venoarterial extracorporeal membrane oxygenation or temporary surgical ventricular assist device as ST-MCS between 2010 and 2016. Read More

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http://dx.doi.org/10.1016/j.athoracsur.2019.01.060DOI Listing
March 2019
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Pretreatment with P2Y12 receptor antagonists in ST-elevation myocardial infarction: a report from the Swedish Coronary Angiography and Angioplasty Registry.

Eur Heart J 2019 Mar 9. Epub 2019 Mar 9.

Department of Cardiology, Sahlgrenska University Hospital, Bruna stråket 16, 41345 Gothenburg, Sweden.

Aims: Pretreatment of patients with ST-elevation myocardial infarction (STEMI) with P2Y12 receptor antagonists is supported by guidelines and is a common practice despite the lack of definite evidence for its benefit.

Methods And Results: Using data from the Swedish Coronary Angiography and Angioplasty Registry on procedures between 2005 and 2016, we stratified all patients who underwent primary percutaneous coronary intervention due to STEMI in Sweden by whether or not they were pretreated with P2Y12 receptor antagonists. We investigated associations between pretreatment with P2Y12 receptor antagonists and the risk of adverse outcomes using propensity score-adjusted mixed-effects logistic regression, which accounted for clustering of patients within hospitals. Read More

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http://dx.doi.org/10.1093/eurheartj/ehz069DOI Listing
March 2019
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A life support-based comprehensive treatment regimen dramatically lowers the in-hospital mortality of patients with fulminant myocarditis: a multiple center study.

Sci China Life Sci 2019 Feb 28. Epub 2019 Feb 28.

Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology; Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, 430030, China.

Fulminant myocarditis (FM) has unacceptable high mortality. This study aimed to evaluate the therapeutic efficacy of a life support-based comprehensive treatment regimen (LSBCTR), a completely novel treatment regimen, for FM. A total of 169 FM patients recruited from January 2008 to December 2018 were divided into two groups: patients receiving LSBCTR (81 cases), which includes (i) mechanical life support (positive pressure respiration, intra-aortic balloon pump with or without extracorporeal membrane oxygenation), (ii) immunomodulation therapy using sufficient doses of glucocorticoids and immunoglobulins, and (iii) application of neuraminidase inhibitors, and those receiving conventional treatment (88 cases). Read More

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http://dx.doi.org/10.1007/s11427-018-9501-9DOI Listing
February 2019
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Procedural and Clinical Outcomes in Management of Bifurcational Lesions in ST Elevation Myocardial Infarction.

Heart Lung Circ 2019 Feb 6. Epub 2019 Feb 6.

Monash Heart, Monash Medical Centre, Melbourne, Vic, Australia.

Background: Bifurcation percutaneous coronary intervention (PCI) remains a challenging frontier in interventional cardiology, especially in the setting of ST-elevation myocardial infarction (STEMI). We examined the procedural and clinical outcomes of this patient subset.

Methods: We conducted a retrospective case-control study. Read More

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http://dx.doi.org/10.1016/j.hlc.2019.01.011DOI Listing
February 2019
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Mechanical Circulatory Support Devices for Cardiogenic Shock: State of the Art.

Crit Care 2019 Mar 9;23(1):76. Epub 2019 Mar 9.

Service de Reánimation Médicale, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Universite Paris-Sud, Paris, France.

This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2019. Other selected articles can be found online at https://www.biomedcentral. Read More

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http://dx.doi.org/10.1186/s13054-019-2368-yDOI Listing
March 2019
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Preoperative Extracorporeal Membrane Oxygenation for Postinfarction Ventricular Septal Defect.

Innovations (Phila) 2019 Feb 11;14(1):75-79. Epub 2019 Feb 11.

1 Department of Cardiac Surgery, Leviev Cardiothoracic and Vascular Center, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

The mortality rate after the development of ventricular septal defect (VSD) remains high despite progress in pharmaceutical therapy, invasive cardiology, and surgical techniques. Although early surgical repair of postinfarction VSD is associated with a high mortality rate, in hemodynamic unstable patients surgery cannot always be postponed and surgical repair may be required urgently. We present two cases of patients diagnosed with postinfarction VSD who were in cardiogenic shock with multiorgan failure despite optimal treatment. Read More

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http://dx.doi.org/10.1177/1556984518823633DOI Listing
February 2019
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In-Hospital Outcomes After Percutaneous Coronary Intervention for Acute Coronary Syndrome With Cardiogenic Shock (from a Japanese Nationwide Registry [J-PCI Registry]).

Am J Cardiol 2019 Feb 22. Epub 2019 Feb 22.

Department of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan.

In-hospital complications and their predictors in acute coronary syndrome (ACS) patients with cardiogenic shock (CS) have not been fully investigated, particularly in those who underwent invasive revascularization procedures. This study investigated the in-hospital outcomes, along with the volume-outcome relationship of ACS patients with CS, using a contemporary large-scale nationwide percutaneous coronary intervention (PCI) registry in Japan. We analyzed PCI procedural data on ACS patients treated between 2014 and 2016 in a nationwide Japanese PCI registry. Read More

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http://dx.doi.org/10.1016/j.amjcard.2019.02.015DOI Listing
February 2019
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Single Ventricle Palliation in a Developing Sub-Saharan African Country: What Should be Improved?

World J Pediatr Congenit Heart Surg 2019 Mar;10(2):164-170

1 Cardio-Thoracic Center, Clínica Girassol, Luanda, Angola.

Introduction:: Single ventricle physiology management is challenging, especially in low-income countries.

Objective:: To report the palliation outcomes of single ventricle patients in a developing African country.

Methods:: We retrospectively studied 83 consecutive patients subjected to single ventricle palliation in a single center between March 2011 and December 2017. Read More

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http://dx.doi.org/10.1177/2150135118822671DOI Listing
March 2019
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Therapeutic Advances in the Management of Cardiogenic Shock.

Am J Ther 2019 Mar/Apr;26(2):e234-e247

University of Medicine "Carol Davila," Bucharest.

Background: Cardiogenic shock (CS) is a life-threatening state of tissue hypoperfusion, associated with a very high risk of mortality, despite intensive monitoring and modern treatment modalities. The present review aimed at describing the therapeutic advances in the management of CS.

Areas Of Uncertainty: Many uncertainties about CS management remain in clinical practice, and these relate to the intensity of invasive monitoring, the type and timing of vasoactive therapies, the risk-benefit ratio of mechanical circulatory support (MCS) therapy, and optimal ventilation mode. Read More

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http://dx.doi.org/10.1097/MJT.0000000000000920DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6404765PMC
March 2020
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How Much Malperfusion Is Too Much in Acute Type A Aortic Dissections?

J Clin Med 2019 Mar 4;8(3). Epub 2019 Mar 4.

Department of Cardiovascular Surgery, Institute for Cardiovascular Diseases, Str. Gh. Adam nr. 13A, 300310 Timisoara, Romania.

(1) Background: Malperfusion is a central limiting factor in the setting of acute Type A aortic dissections (AAAD). We sought to find preoperative metabolic acidosis thresholds that might influence decision-making in this setting. (2) Methods: We retrospectively reviewed consecutive patients operated on with AAAD between January 2002 and December 2017. Read More

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http://dx.doi.org/10.3390/jcm8030304DOI Listing
March 2019
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Outcomes following venoarterial extracorporeal membrane oxygenation in children with refractory cardiogenic disease.

Eur J Pediatr 2019 Mar 4. Epub 2019 Mar 4.

Department of Extracorporeal Circulation and Extracorporeal Life Support, Heart Institute, Zhejiang University School of Medicine Children's Hospital, 3333 Binsheng Road, Binjiang District, Hangzhou, 310052, Zhejiang, China.

Retrospective analysis was performed at an affiliated university children's hospital with consecutive patients receiving a venoarterial extracorporeal membrane oxygenation (VA-ECMO) for refractory cardiogenic shock from July 2007 to May 2018. Fifty-six patients underwent VA-ECMO for refractory cardiogenic shock with the median age of 39.0 (1. Read More

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http://link.springer.com/10.1007/s00431-019-03352-5
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http://dx.doi.org/10.1007/s00431-019-03352-5DOI Listing
March 2019
3 Reads

Coxsackie B2 Virus Infection Causing Multiorgan Failure and Cardiogenic Shock in a 42-Year-Old Man.

Tex Heart Inst J 2019 02 1;46(1):32-35. Epub 2019 Feb 1.

Infections from coxsackie B2 viruses often cause viral myocarditis and, only rarely, multisystem organ impairment. We present the unusual case of a 42-year-old man in whom coxsackie B2 virus infection caused multiorgan infection, necessitating distal pancreatectomy, splenectomy, renal dialysis, and venoarterial extracorporeal membrane oxygenation with mechanical ventilation. In addition, the patient had a rapid-eye-movement sleep-related conduction abnormality that caused frequent sinus pauses of longer than 10 s, presumably due to myocarditis from the coxsackievirus infection. Read More

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http://dx.doi.org/10.14503/THIJ-17-6361DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378994PMC
February 2019
2 Reads

Culprit-Only or Complete Revascularization for ST-Elevation Myocardial Infarction in Patients with and Without Shock.

Interv Cardiol Clin 2019 Apr;8(2):225-234

Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, West Campus, Baker 4, Boston, MA 02215, USA. Electronic address:

ST-elevation myocardial infarction (STEMI) patients with multivessel disease and without shock are a common clinical entity, but the best approach to nonculprit vessel lesions remains controversial. In contrast, STEMI patients with shock do not appear to benefit from primary multivessel percutaneous coronary interventions (PCIs) during the index procedure. The optimal treatment strategy in a given STEMI patient involves an individualized approach, incorporating clinical, hemodynamic, and angiographic/imaging parameters. Read More

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http://dx.doi.org/10.1016/j.iccl.2019.01.001DOI Listing
April 2019
1 Read