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    1 OF 249

    Acute heart failure : An unmet medical need.
    Herz 2017 Sep 22. Epub 2017 Sep 22.
    Department of Internal Medicine III - Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Ernst-Grube-Strasse 40, Halle (Saale), 06120, Germany.
    Despite recent advances in the management of heart failure with reduced ejection fraction (HFrEF), the burden of acute heart failure (AHF) remains significant with a high morbidity and mortality that has not been improved by any treatment modality. A meta-analysis summarized the study results on the effects of tolvaptan on AHF, which failed to demonstrate an improvement in short-term and long-term mortality, length of hospital stay and reduced frequency of worsening heart failure (WHF). Similar trial results were also reported in other AHF studies, such as the ASCEND-HF and the RELAX-AHF-2 trials. Read More

    Extracorporeal Membrane Oxygenation (ECMO) and the Critical Cardiac Patient.
    Curr Transplant Rep 2017 10;4(3):218-225. Epub 2017 Jul 10.
    Advanced Heart Failure, Transplantation and MCS, Sentara Heart Hospital, 600 Gresham Drive, Norfolk, VA 23507 USA.
    Purpose Of Review: This review is to summarize the basics of veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) as it is utilized for critically ill cardiac patients.

    Recent Findings: ECMO may be instituted in a variety of health care settings, from the emergency room to the operating room. The types of patients who may benefit from ECMO are reviewed in detail. Read More

    Experience with the SynCardia total artificial heart in a Canadian centre.
    Can J Surg 2017 Oct 1;60(6):3617. Epub 2017 Oct 1.
    From the Department of Cardiac Surgery, Montreal Heart Institute and Université de Montréal, Montreal, Que. (Nguyen, Pellerin, Perrault, Carrier); and the Department of Medicine, Montreal Heart Institute and Université de Montréal, Montreal, Que. (White, Ducharme, Racine).
    Background: The SynCardia total artificial heart (TAH) provides complete circulatory support by replacing both native ventricles. Accepted indications include bridge to transplantation and destination therapy. We review our experience with TAH implantation during a period when axial flow pump became available. Read More

    Stress Cardiomyopathy Managed with Extracorporeal Support after Self-Injection of Epinephrine.
    Case Rep Crit Care 2017 27;2017:3731069. Epub 2017 Aug 27.
    Réanimation des Urgences et Médicale, Assistance Publique Hôpitaux de Marseille, CHU la Timone 2, Aix-Marseille Université, Marseille, France.
    A 28-year-old man was admitted to the ICU for self-injection of Epinephrine. This injection resulted in the rapid development of a catecholamine-induced cardiomyopathy (inverted Takotsubo) with a severe cardiogenic shock. The importance of ventricular dysfunction required the implementation of a temporary arteriovenous circulatory support until the recovery of myocardial stunning. Read More

    The electrocardiographic "triangular QRS-ST-T waveform" pattern in patients with ST-segment elevation myocardial infarction: Incidence, pathophysiology and clinical implications.
    J Electrocardiol 2017 Aug 16. Epub 2017 Aug 16.
    Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy.
    Background: A specific ECG pattern of presentation of ST-segment elevation acute myocardial infarction (STEMI), characterized by "triangular QRS-ST-T waveform" (TW), has been associated with poor in-hospital prognosis but longitudinal data on its incidence and clinical impact are lacking. We prospectively evaluated the incidence and prognostic meaning of the TW pattern in a cohort of consecutive STEMI patients.

    Methods: All STEMI patients who presented within 12h of symptoms onset and showed no complete bundle branch block or paced ventricular rhythm were included. Read More

    Contemporary Management of Cardiogenic Shock: A Scientific Statement From the American Heart Association.
    Circulation 2017 Sep 18. Epub 2017 Sep 18.
    Cardiogenic shock is a high-acuity, potentially complex, and hemodynamically diverse state of end-organ hypoperfusion that is frequently associated with multisystem organ failure. Despite improving survival in recent years, patient morbidity and mortality remain high, and there are few evidence-based therapeutic interventions known to clearly improve patient outcomes. This scientific statement on cardiogenic shock summarizes the epidemiology, pathophysiology, causes, and outcomes of cardiogenic shock; reviews contemporary best medical, surgical, mechanical circulatory support, and palliative care practices; advocates for the development of regionalized systems of care; and outlines future research priorities. Read More

    In-hospital outcomes of acute myocardial infarction with cardiogenic shock caused by right coronary artery occlusion vs. left coronary artery occlusion.
    Cardiovasc Interv Ther 2017 Sep 16. Epub 2017 Sep 16.
    Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan.
    In-hospital outcomes of acute myocardial infarction (AMI) with cardiogenic shock (CS) were still not satisfactory even in the primary percutaneous coronary intervention (PCI) era. The aim of this study was to compare in-hospital outcomes of AMI with CS caused by right coronary artery (RCA) occlusion vs. left coronary artery (LCA) occlusion. Read More

    Epidemiology, pathogenesis, and management of takotsubo syndrome.
    Clin Auton Res 2017 Sep 15. Epub 2017 Sep 15.
    Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Sjukhusbacken 10, 118 83, Stockholm, Sweden.
    Takotsubo syndrome is a recently recognized acute cardiac disease entity with a clinical presentation resembling that of an acute coronary syndrome. The typical takotsubo syndrome patient has a unique circumferential left (bi-) ventricular contraction abnormality profile that extends beyond a coronary artery supply territory and appears to follow the anatomical cardiac sympathetic innervation. The syndrome predominantly affects postmenopausal women and is often preceded by emotional or physical stress. Read More

    Reverse Takotsubo Cardiomyopathy and Cardiogenic Shock Associated With Methamphetamine Consumption.
    J Emerg Med 2017 Sep 12. Epub 2017 Sep 12.
    Hillingdon Hospital, London, United Kingdom.
    Background: Reverse Takotsubo cardiomyopathy is characterized by transient myocardial hypokinesia affecting predominantly the basal myocardial wall. It is a rare variant of Takotsubo cardiomyopathy affecting younger patients.

    Case Report: We report a case of a young man who having consumed methamphetamines presented with cardiogenic shock and severe left ventricular systolic dysfunction, affecting predominantly the basal segments with sparing of the apex. Read More

    Temporary Mechanical Circulatory Support for Cardiogenic Shock.
    Curr Treat Options Cardiovasc Med 2017 Sep 14;19(10):77. Epub 2017 Sep 14.
    University of Kentucky Gill Heart Institute, First Floor, Room G100, 1000 S. Limestone, Lexington, KY, 40536, USA.
    Opinion Statement: Cardiogenic shock is a life-threatening presentation of severe heart failure with high morbidity and mortality. Given the modest increased in cardiac output and neutral/negative survival benefits with today's available inotropes (namely, dobutamine and milrinone), the use of mechanical circulatory support (MCS) has increased dramatically over the past 2 decades. In this review article, we discuss the physiologic concept, clinical evidence of benefit, and current use and indications/potential complications of the four most commonly used devices for MCS: intra-aortic balloon pump, Impella percutaneous ventricular assist device, TandemHeart, and extracorporeal membrane oxygenation (ECMO). Read More

    Extracorporeal membrane oxygenation in adult patients with acute fulminant myocarditis : Clinical outcomes and risk factor analysis.
    Herz 2017 Sep 12. Epub 2017 Sep 12.
    Department of Anesthesiology, Zhongshan Hospital Affiliated to Sun Yat-sen University, East Sunwen Road, Zhongshan City, 528403, Zhongshan, Guangdong Province, China.
    Background: Our study aimed to summarize the clinical outcomes of extracorporeal membrane oxygenation (ECMO) in adult patients with acute fulminant myocarditis and to investigate the risk factors associated with its application.

    Patients And Methods: We retrospectively examined patients with cardiogenic shock and acute fulminant myocarditis. The following data were collected: patients' preoperative general condition, related clinical factors during ECMO, complications, and outcomes of ECMO. Read More

    Patient and Physician Perspectives on Public Reporting of Mortality Ratings for Percutaneous Coronary Intervention in New York State.
    Circ Cardiovasc Qual Outcomes 2017 Sep;10(9)
    From the Division of Cardiology, University of Rochester Medical Center, Rochester, New York (G.F., C.R.N., J.B., F.S.L.); and University of Rochester School of Medicine, New York (B.A.).
    Background: Public reporting of physician-specific outcome data for procedures, such as percutaneous coronary intervention (PCI), can influence physicians to avoid high-risk patients who may benefit from treatment. Prior physician attitudes toward public scorecards in New York State (NYS) have been studied, but the exclusion criteria have evolved. Additionally, patient perceptions toward such reports remain poorly understood. Read More

    Integrating invasive hemodynamic parameters into risk stratification of acute myocardial infarction and cardiogenic shock.
    Catheter Cardiovasc Interv 2017 Sep;90(3):396-397
    The Icahn School of Medicine at Mount Sinai, New York, New York.
    A ratio of systolic blood pressure over left ventricle end-diastolic pressure (SBP/LVEDP) ≤4 identifies patients with ST-elevation myocardial infarction (STEMI) at greater risk of in-hospital mortality or that may require the use of mechanical circulatory support (MCS). The predictive performance of the SBP/LVEDP ratio was comparable to non-invasive hemodynamic parameters (the shock index and the modified shock index) and established clinical risk stratification tools (the TIMI risk score). Alongside established clinical risk factors, invasive hemodynamic parameters may help in identifying STEMI patients who may benefit from early MCS. Read More

    Predictive value of SYNTAX score II for clinical outcomes in cardiogenic shock underwent primary percutaneous coronary intervention; a pilot study.
    Int J Cardiovasc Imaging 2017 Sep 9. Epub 2017 Sep 9.
    Department of Cardiology, Başkent University Faculty of Medicine, Istanbul, Turkey.
    SYNTAX Score II (SSII) connects clinical variables with coronary anatomy. We investigated the prognostic value of SSII in patients with ST segment elevated myocardial infarction (STEMI) complicated with cardiogenic shock treated with primary percutaneous coronary intervention (PPCI). In this retrospective analysis, we evaluated the in-hospital prognostic impact of SSII on 492 patients with STEMI complicated with cardiogenic shock treated with PPCI. Read More

    Impact of Center Left Ventricular Assist Device Volume on Outcomes After Implantion: An INTERMACS Analysis.
    JACC Heart Fail 2017 Aug 30. Epub 2017 Aug 30.
    Cardiac Surgery, St. Vincent Heart Center, Indianapolis, Indiana.
    Objectives: This study examined patient outcomes after left ventricular assist device (LVAD) implantation across a range of center surgical volumes.

    Background: In order for a center to qualify for reimbursement, Centers for Medicare and Medicaid Services (CMS) requires it to implant ≥10 LVADs or total artificial hearts over a 3-year period. The impact of center LVAD surgical volumes on patient outcomes has not been thoroughly scrutinized. Read More

    Sex-based differences in quality of care and outcomes in a health system using a standardized STEMI protocol.
    Am Heart J 2017 Sep 17;191:30-36. Epub 2017 Jun 17.
    Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA.
    Background: Recent data from the National Cardiovascular Data Registry indicate that women with ST-segment-elevation myocardial infarction (STEMI) continue to have higher mortality and reported delays in treatment compared with men. We aimed to determine whether the sex difference in mortality exists when treatment disparities are reduced.

    Methods: Using a prospective regional percutaneous coronary intervention (PCI)-based STEMI system database with a standardized STEMI protocol, we evaluated baseline characteristics, treatment, and clinical outcomes of STEMI patients stratified by sex. Read More

    Cardiac Support: Emphasis on Venoarterial ECMO.
    Crit Care Clin 2017 Oct 21;33(4):777-794. Epub 2017 Jul 21.
    Department of Cardiothoracic Surgery, Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, VA 22042, USA.
    Major advances have been made in mechanical circulatory support in recent years. Venoarterial (VA) extracorporeal membrane oxygenation (ECMO) provides both pulmonary and circulatory support for critically ill patients with hemodynamic compromise, serving as a bridge to recovery or definitive therapy in the form of transplant or a durable ventricular assist device. In the past, VA ECMO support was used in cases of cardiogenic shock or failure to wean from cardiopulmonary bypass; however, the technology is now being applied to an ever-expanding list of conditions, including massive pulmonary embolism, cardiac arrest, drug overdose, and hypothermia. Read More

    Impact of age on extracorporeal membrane oxygenation survival of patients with cardiac failure.
    Clin Interv Aging 2017 24;12:1347-1353. Epub 2017 Aug 24.
    Department of Internal Medicine, St Vincent's Hospital, The Catholic University of Korea, Suwon, South Korea.
    Purpose: Extracorporeal membrane oxygenation (ECMO) is used to treat patients in critical condition with cardiogenic shock. However, few studies have examined the effect of old age in ECMO survival. This study analyzed the impact of age on ECMO survival of patients with cardiac failure, and analyzed predictive factors for survival according to age. Read More

    A dual therapy of off-pump temporary left ventricular extracorporeal device and amniotic stem cell for cardiogenic shock.
    J Cardiothorac Surg 2017 Sep 7;12(1):80. Epub 2017 Sep 7.
    Department of Surgery, Division of Cardiothoracic Surgery, University of Arizona, Tucson, AZ, USA.
    Background: Temporary mechanical circulatory support device without sternotomy has been highly advocated for severe cardiogenic shock patient but little is known when coupled with amniotic stem cell therapy.

    Case Presentation: This case reports the first dual therapy of temporary left ventricular extracorporeal device CentriMag with distal banding technique and human amniotic stem cell injection for treating a severe refractory cardiogenic shock of an 68-year-old female patient. A minimally-invasive off-pump LVAD was established by draining from the left ventricle and returning to the right axillary artery with distal arterial banding to prevent right upper extremity hyperperfusion. Read More

    Percutaneous extracorporeal membrane oxygenation in electrical storm: five case reports addressing efficacy, transferring allowance or radiofrequency ablation support.
    Eur Heart J Acute Cardiovasc Care 2017 Sep 1:2048872617730036. Epub 2017 Sep 1.
    Department of Cardiology, University Hospital of Salamanca - IBSAL, Salamanca, Spain.
    Extracorporeal membrane oxygenation systems have undergone rapid technological improvements and are now feasible options for medium-term support of severe cardiac or pulmonary failure. We report five cases of electrical storm that was rescued by the insertion of peripheral veno-arterial extracorporeal membrane oxygenation systems. This device could help to restore systemic circulation as well as permitting organ perfusion in patients with cardiogenic shock in relation to electrical storm thus achieving greater electrical stability. Read More

    Development and validation of a clinical risk score to predict mortality after percutaneous coronary intervention.
    Open Heart 2017 25;4(2):e000576. Epub 2017 Jul 25.
    Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK.
    Objective: To develop and validate a contemporary clinical risk score to predict mortality after percutaneous coronary intervention (PCI).

    Methods: Using data collected from patients undergoing PCI at the South Yorkshire Cardiothoracic Centre, Sheffield, UK, between January 2007 and September 2013, a risk score was developed to predict mortality. Logistic regression was used to evaluate the effect of each variable upon 30-day mortality. Read More

    Successful treatment of aortic root dissection complicated with extensive myocardial infarction using the total artificial heart.
    J Surg Case Rep 2017 Aug 30;2017(8):rjx123. Epub 2017 Aug 30.
    Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.
    Acute Type A aortic dissection is a surgical emergency. Urgent repair is indicated to avoid complications such as acute aortic insufficiency, coronary ischemia and aortic rupture with cardiac tamponade. This report details the management of a patient with acute Type A aortic dissection complicated by an extensive anterolateral myocardial infarction and cardiogenic shock who was successfully bridged to transplantation with a total artificial heart. Read More

    Role of percutaneous veno-arterial extracorporeal membrane oxygenation as bridge to left ventricular assist device.
    J Artif Organs 2017 Sep 4. Epub 2017 Sep 4.
    Department of Transplantation, National Cerebral and Cardiovascular Center, Suita, Japan.
    Percutaneous veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides emergency circulatory support for cardiogenic shock patients and is used as a bridge to a left ventricular assist device (LVAD). The purpose of this study was to determine risk factors for LVAD implantation in patients who required percutaneous VA-ECMO as a bridge to long-term LVAD. We retrospectively investigated 32 consecutive LVAD patients who required percutaneous VA-ECMO as a bridge to long-term LVAD. Read More

    Four-year experience of providing mobile extracorporeal life support to out-of-center patients within a suprainstitutional network-Outcome of 160 consecutively treated patients.
    Resuscitation 2017 Sep 11. Epub 2017 Sep 11.
    Department of Cardiovascular Surgery, Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.
    Aim: Mobile extracorporeal life support (ECLS) may soon be on the verge to become a fundamental part of emergency medicine. Here, we report on our four-year experience of providing advanced mechanical circulatory support for out-of-center patients within the Düsseldorf ECLS Network (DELSN).

    Methods: This retrospective cohort study analyses the outcome of 160 patients with refractory circulatory failure consecutively treated with mobile veno-arterial extracorporeal membrane oxygenation (vaECMO) between July 2011 and October 2015 within the DELSN. Read More

    Cause of Death Following Surgery for Acute Type A Dissection: Evidence from the Canadian Thoracic Aortic Collaborative.
    Aorta (Stamford) 2017 Apr 1;5(2):33-41. Epub 2017 Apr 1.
    Division of Cardiac Surgery, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
    Background: Surgery confers the best chance of survival following acute Type A dissection (ATAD), yet perioperative mortality remains high. Although perioperative risk factors for mortality have been described, information on the actual causes of death is sparse. In this study, we aimed to characterize the inciting events causing death during surgical repair of ATAD. Read More

    Bare metal versus drug eluting stents for ST-segment elevation myocardial infarction in the TOTAL trial.
    Int J Cardiol 2017 Dec 30;248:120-123. Epub 2017 Aug 30.
    Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada. Electronic address:
    Background: The safety and efficacy of drug eluting stents (DES) in the setting of ST elevation myocardial infarction (STEMI) is not well established.

    Methods: In the TOTAL trial, patients presenting with STEMI were randomized to routine thrombectomy versus PCI alone. In this post-hoc analysis, propensity matching was used to assess relative safety and efficacy according to type of stent used. Read More

    Trends in the Incidence and In-Hospital Outcomes of Cardiogenic Shock Complicating Thyroid Storm.
    Am J Med Sci 2017 Aug 25;354(2):159-164. Epub 2017 Apr 25.
    Department of Anesthesiology, Mayo Clinic, Phoenix, Arizona.
    Background: Thyroid storm (TS) constitutes an endocrine emergency with an incidence of up to 10% of all admissions for thyrotoxicosis. Cardiogenic shock (CS) is a rare complication of TS and very limited data exists on its incidence and outcomes. We aimed to estimate the national trends in incidence and outcomes of CS among patients admitted to US hospitals with TS. Read More

    Utilization of the Impella for hemodynamic support during percutaneous intervention and cardiogenic shock: an insight.
    Expert Rev Med Devices 2017 Oct 11;14(10):789-804. Epub 2017 Sep 11.
    b Department of cardiology , University of Miami Miller School of Medicine , Miami , FL , USA.
    Introduction: Impella is a catheter-based micro-axial flow pump placed across the aortic valve, and it is currently the only percutaneous left ventricular assist device approved for high-risk percutaneous coronary intervention and cardiogenic shock. Areas Covered: Even though several studies have repeatedly demonstrated the excellent hemodynamic profile of Impella in high-risk settings, it remains underutilized. Here we aim to provide an up-to-date summary of the available literature on Impellas use in High risk settings as well as the practical aspects of its usage. Read More

    Advanced Percutaneous Mechanical Circulatory Support Devices for Cardiogenic Shock.
    Crit Care Med 2017 Aug 28. Epub 2017 Aug 28.
    1Critical Care Medicine, National Institutes of Health Clinical Center, Bethesda, MD. 2Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, Bethesda, MD.
    Objectives: To review temporary percutaneous mechanical circulatory support devices for the treatment of cardiogenic shock, including current evidence, contraindications, complications, and future directions.

    Data Sources: A MEDLINE search was conducted with MeSH terms: cardiogenic shock, percutaneous mechanical circulatory support, extracorporeal membrane oxygenation, Impella, and TandemHeart.

    Study Selection: Selected publications included randomized controlled trial data and observational studies describing experience with percutaneous mechanical circulatory support in cardiogenic shock. Read More

    Hemodynamic Support Devices for Shock and High-Risk PCI: When and Which One.
    Curr Cardiol Rep 2017 Aug 31;19(10):100. Epub 2017 Aug 31.
    VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia, USA.
    Purpose Of Review: This article addresses evolving devices and uses of hemodynamic support in the management of high-risk PCI and AMI with cardiogenic shock.

    Recent Findings: Recent publications question the benefit of Intra-aortic Balloon Pump support for AMI Shock. Furthermore, in high-risk PCI, the Impella support system provides better late outcomes than does the intra-aortic balloon pump. Read More

    Pledget Induced Cardiogenic Shock Following a Minimally Invasive Aortic Valve Replacement.
    J La State Med Soc 2017 Jul-Aug;169(4):94-95. Epub 2017 Aug 28.
    Department of Cardiovascular and Thoracic Surgery, Lafayette General Medical Center - Lafayette, LA.
    Within the last decade, minimally invasive valve replacements have become exceedingly popular, and as a result, so has the rise of technology aimed at refining and simplifying these techniques. With new technology, new complications are inevitable. We present a routine Minimally invasive aortic valve replacement through a right anterior minithoracotomy complicated by pledget impaction in a coronary artery. Read More

    The Prognostic Risk Factors of ECMO in Patients with Cardiogenic Shock: A Retrospective Cohort Analysis.
    Heart Surg Forum 2017 08 28;20(4):E170-E177. Epub 2017 Aug 28.
    Department of Anesthesiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
    Background: Advances in ECMO have rapidly progressed in recent years; however, the clinical mortality rate remains high. This study aimed to identify the risk factors of ECMO in patients with cardiogenic shock.

    Methods: Data of patients with cardiogenic shock who received ECMO from January 2006 to August 2013 at the Affiliated Hospital of Sun Yat-Sen University were retrospectively analyzed. Read More

    Post-Myocardial Infarction Ventricular Septal Defect Six Months following Coronary Artery Bypass Grafting.
    Heart Surg Forum 2017 08 25;20(4):E162-E163. Epub 2017 Aug 25.
    Division of Cardiac Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
    Mechanical complications following acute myocardial infarction are associated with high mortality. We present the first reported case of a new post myocardial infarction ventricular septal defect (VSD) within six months of coronary artery bypass grafting. The patient underwent successful surgical correction of the VSD with the assistance of mechanical circulatory support (MCS). Read More

    Acute Heart Failure Exacerbation with Cardiogenic Shock and Elevated Systemic Vascular Resistance Treated with a Combination of Nicardipine and Dobutamine Therapy.
    Case Rep Cardiol 2017 6;2017:7329213. Epub 2017 Aug 6.
    Department of Internal Medicine, Advanced Heart Failure/Transplant Cardiology, Rush University Medical Center, 1653 W. Congress Pkwy, Chicago, IL 60612, USA.
    Acute heart failure is a common reason for hospital admission and is usually caused by decreased cardiac output either as a result of an intrinsic cardiac issue or as a result of severe hypertension with elevated afterload. We present a patient with a history of HFrEF who presented with acute heart failure, found to have hypotension requiring Dobutamine support and an elevated systemic vascular resistance requiring Nicardipine drip, with subsequent recovery of cardiac function. Read More

    A Case of Cardiogenic Shock Secondary to Complement-Mediated Myopericarditis From Influenza B Infection.
    Can J Cardiol 2017 Oct 15;33(10):1335.e1-1335.e3. Epub 2017 Jun 15.
    Department of Cardiology, NYU Langone Medical Center, New York, New York, USA. Electronic address:
    Influenza B is a rare cause of myocarditis that is usually caused by histiocytic and mononuclear cellular infiltrates. We describe a 22-year-old female patient presenting with fulminant myopericarditis secondary to influenza B infection that deteriorated to cardiogenic shock. Endomyocardial biopsy results yielded myocardial necrosis through complement-mediated cellular injury without evidence of interstitial infiltrates. Read More

    Transcatheter vs Surgical Aortic Valve Replacement for Aortic Stenosis in Low-Intermediate Risk Patients: A Meta-analysis.
    Can J Cardiol 2017 Sep 15;33(9):1171-1179. Epub 2017 Jun 15.
    Division of Cardiac Surgery, Department of Surgery, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada. Electronic address:
    Background: Transcatheter aortic valve replacement (TAVR) has emerged as the treatment of choice for patients with severe aortic stenosis at high surgical risk; the role of TAVR compared with surgical aortic valve replacement (SAVR) in the low-intermediate surgical risk population remains uncertain. Our primary objective was to determine differences in 30-day and late mortality in patients treated with TAVR compared with SAVR at low-intermediate risk (Society of Thoracic Surgeons Predicted Risk of Mortality < 10%).

    Methods: Medline and Embase were searched from 2010 to March 2017 for studies that compared TAVR with SAVR in the low-intermediate surgical risk population, restricted to randomized clinical trials and matched observational studies. Read More

    High rate of arterial complications in patients supported with extracorporeal life support for drug intoxication-induced refractory cardiogenic shock or cardiac arrest.
    J Thorac Dis 2017 Jul;9(7):1988-1996
    Department of Cardiac Surgery, "Louis Pradel" Cardiologic Hospital, "Claude Bernard" University, Lyon, France.
    Background: Cardiac failure is still a leading cause of death in drug intoxication. Extracorporeal life support (ECLS) could be used as a rescue therapeutic option in patients developing refractory cardiogenic shock or cardiac arrest. The aim of this report is to present our results of ECLS in the setting of poisoning from cardiotoxic drugs. Read More

    Baseline serum bicarbonate levels independently predict short-term mortality in critically ill patients with ischaemic cardiogenic shock.
    Eur Heart J Acute Cardiovasc Care 2016 Dec 1:2048872616683526. Epub 2016 Dec 1.
    3 Department of Intensive Care Medicine, Bern University Hospital, Switzerland.
    Background: Cardiogenic shock is a feared complication of acute myocardial infarction with high mortality rates. Data on the predictive role of acid base dysregulation in this clinical setting are sparse. We therefore embarked on investigating the predictive role of serum bicarbonate in critically ill intensive care unit (ICU) patients with cardiogenic shock. Read More

    Anticoagulation of Percutaneous Ventricular Assist Device Using Argatroban-Based Purge Solution: A Case Series.
    J Pharm Pract 2017 Jan 1:897190017727191. Epub 2017 Jan 1.
    1 Department of Pharmacy, Henry Ford Hospital, Detroit, MI, USA.
    Impella devices are percutaneously inserted ventricular assist devices which require a continuous purge solution that contains heparin to prevent pump thrombosis and device failure. We describe 2 patients with heparin-induced thrombocytopenia (HIT) supported with an Impella device utilizing an argatroban-based purge solution. Case 1 involved an 83-year-old female with biventricular failure which resulted in right ventricle Impella support. Read More

    Cardiogenic shock with ST-segment elevation acute coronary syndrome (ReNa-Shock ST).
    Medicina (B Aires) 2017 ;77(4):261-266
    área de Investigación y Consejo de Emergencias Cardiovasculares, Sociedad Argentina de Cardiología (SAC), Buenos Aires, Argentina.
    Cardiogenic shock (CS) in the setting of an ST-segment elevation myocardial infarction (STEMI) is a severe complication and constitutes one of the principal causes of death associated with this condition. The aim of this study was to describe the clinical characteristics, treatment strategies and hospital outcome of CS associated with STEMI in Argentina. The Argentine Registry of Cardiogenic Shock (ReNA-Shock) was a prospective and multicenter registry of consecutive patients with CS hospitalized in 64 centers in Argentina between July 2013 and May 2015. Read More

    Association Between Health Insurance Status and In-Hospital Outcomes After ST-Segment Elevation Myocardial Infarction.
    Am J Cardiol 2017 Oct 17;120(7):1049-1054. Epub 2017 Jul 17.
    Division of Cardiology, Apex Heart Institute, Ahmedabad, India.
    Lack of health insurance is associated with adverse clinical outcomes; however, association between health insurance status and outcomes in patients presenting with ST-elevation myocardial infarction (STEMI) is unclear. Using the Nationwide Inpatient Sample data from 2003 to 2014, hospitalizations with STEMI in patients 18 years of age and older were extracted. Based on health insurance status, patients were categorized into insured and uninsured groups. Read More

    Central Cannulation as a Viable Alternative to Peripheral Cannulation in Extracorporeal Membrane Oxygenation.
    Semin Thorac Cardiovasc Surg 2017 Summer;29(2):188-195. Epub 2017 Feb 20.
    Department of Surgery, Duke University Medical Center, Durham, North Carolina. Electronic address:
    Arterial cannulation for veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) is most commonly established via the aorta, axillary, or femoral vessels, yet their inherent complications are not well characterized. The purpose of this study was to compare the outcomes and complication rates of central vs peripheral cannulation. Adult patients undergoing VA ECMO between June 2009 and April 2015 were reviewed in this retrospective single-center study. Read More

    Extracorporeal membrane oxygenation in pheochromocytoma-induced cardiogenic shock.
    Asian Cardiovasc Thorac Ann 2017 Jan 1:218492317727995. Epub 2017 Jan 1.
    2 Department of Surgery, Montreal Heart Institute, 25465 Université de Montréal, Montreal, Canada.
    Extracorporeal membrane oxygenation has been extensively used for cardiopulmonary support in cardiogenic shock. However, its clinical value in the management of pheochromocytoma crisis remains unclear. We report a rare case of life-threatening cardiogenic shock managed with peripheral venoarterial extracorporeal membrane oxygenation combined with endovascular left ventricular venting, in a 40-year-old female patient, in the setting of unknown adrenal pheochromocytoma. Read More

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