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Impella to Treat Acute Myocardial Infarct-Related Cardiogenic Shock

Research output: Contribution to journalReviewpeer-review


  1. Refractory in-hospital cardiac arrest - no time to waste

    Research output: Contribution to journalEditorialpeer-review

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Acute myocardial infarction complicated by cardiogenic shock (AMICS), is characterized by critically low cardiac output and decreased myocardial contractility. In this situation, a treatment that unloads the myocardium and restores CO without increasing the myocardial oxygen demand is theoretically appealing. Axial flow pumps offer hemodynamic support without increasing myocardial oxygen consumption. Consequently, the use of axial flow pumps, especially the Impella devices, is increasing. It is likely that the SCAI C patient with predominantly left ventricular failure and without prolonged cardiac arrest is the best candidate for these devices. Registry data suggest that pre-PCI Impella may be advantageous to post-PCI placement. However, several gaps in knowledge exist regarding optimal patient selection, futility criteria, timing, weaning and escalation strategy, and until data from adequately sized randomized trials are available, immediate individual evaluation for mechanical circulatory support by a shock team is warranted when a patient is diagnosed with AMICS.

Original languageEnglish
Article number2427
JournalJournal of Clinical Medicine
Issue number9
Publication statusPublished - 26 Apr 2022

    Research areas

  • acute myocardial infarction, cardiogenic shock, mechanical circulatory support

ID: 77990293