- Email: [email protected]
Cardiac Arrest in Acute Myocardial Infarction: Concept of Circulatory Support With Mechanical Chest Compression and Impella to Facilitate Percutaneous Coronary Intervention
HLC 2301 No. of Pages 4
BRIEF COMMUNICATION
Heart, Lung and Circulation (2017) xx, 1–4 1443-9506/04/$36.00 http://dx.doi.org/10.1016/j.hlc.2017.01.012
Cardiac Arrest in Acute Myocardial Infarction: Concept of Circulatory Support With Mechanical Chest Compression and Impella to Facilitate Percutaneous Coronary Intervention Kaleab N. Asrress, PhD a,b,c*, Maciej Marciniak, PhD a, Natalia Briceno, MBBS a, Divaka Perera, MD a a
King’s College London British Heart Foundation Centre of Excellence, The Rayne Institute, St. Thomas’ Hospital, London, England Department of Cardiology, Royal North Shore Hospital, Sydney, NSW, Australia c The Kolling Institute, Northern Clinical School, University of Sydney, Australia b
Received 3 January 2017; accepted 15 January 2017; online published-ahead-of-print xxx
Cardiogenic shock in the context of acute ST-elevation myocardial infarction (STEMI) remains a challenge to manage and results in significant mortality and morbidity, cardiac arrest in this setting even more so. The increase in myocardial oxygen demand and consumption with the use of inotropes is recognised as increasing mortality. Alternatives include the intra-aortic balloon pump (IABP), which has yet to be shown to improve outcomes, and extracorporeal membrane oxygenation (ECMO), which requires super-specialised techniques not widely available. We report a case of Anterior STEMI from a left main stem occlusion suffering with cardiac arrest on reaching the catheter laboratory table necessitating external mechanical compression with an AutopulseTM. The patient remained in pulseless electrical activity (PEA) throughout, and was Autopulse dependent despite successful percutaneous coronary intervention (PCI). An Impella1[1_TD$IF] was inserted for additional mechanical support and facilitated successful weaning from cardiopulmonary resuscitation (CPR). Despite 105 minutes without a spontaneous output, we describe the first documented case of simultaneous use of Impella with mechanical CPR with a successful outcome; demonstrating a potential technique of good mechanical haemodynamic support to aide early revascularisation that may have potential utility in the treatment of cardiogenic shock and arrest. [12_TD$IF]Keywords
Cardiac arrest Percutaneous coronary intervention Circulatory support Automated CPR
Case A 56-year-old male was brought to the cardiac catheter laboratory with anterior ST-elevation, and widespread T-wave inversion. He was transferred directly to the cardiac catheter laboratory and found to be in cardiogenic shock with a blood pressure of 80/50 mmHg, diminished consciousness
and cool peripheries. He then developed profound bradycardia and hypotension, treated with temporary transvenous right ventricular pacing. Three episodes of ventricular tachycardia and two of ventricular fibrillation were treated with direct current cardioversion to pulseless electrical activity (PEA). Initial arterial blood gas revealed a pH of 7.04. An AutopulseTM (ZOLL Medical, Chelmsford, MA) was
*Corresponding author at: Department of Cardiology, 5th Floor, Acute Services Building, Royal North Shore Hospital, Reserve Road, St Leonard’s, Sydney, NSW, 2065, Australia. Tel.: +612 9463 2506; fax: +612 9463 2053., Email: [email protected] © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.? V. All rights reserved.
Please cite this article in press as: Asrress KN, et al. Cardiac Arrest in Acute Myocardial Infarction: Concept of Circulatory Support With Mechanical Chest Compression and Impella to Facilitate Percutaneous Coronary Intervention. Heart, Lung and Circulation (2017), http://dx.doi.org/10.1016/j.hlc.2017.01.012
HLC 2301 No. of Pages 4
2
K.N. Asrress et al.
Figure 1 A: Initial coronary angiogram showing critical distal left main stem lesion (arrow) and the challenge of percutaneous intervention with mechanical CPR with several radiopaque items seen. B: Simultaneous kissing stents deployed in the left anterior descending and left circumflex into left main stem. C: Final coronary angiographic result. D: Positioning of Impella CP into left ventricle with the pigtail of catheter (bottom arrow), inflow in the left ventricular outflow tract (middle arrow) and outflow port in the ascending aorta (top arrow) during automated mechanical CPR.
positioned for ongoing mechanical cardiopulmonary resuscitation (CPR). Femoral arterial pressure of 85 mmHg with compression was achieved, and the patient was intubated and ventilated. Coronary angiography revealed an occluded left main coronary artery (LMS), with re-establishment of flow with guide catheter injection. This revealed a critical distal LMS, proximal left anterior descending (LAD) and dominant left circumflex lesions (LCx) (Figure 1A). These were treated with simultaneous kissing stents into LAD and LCx (Figure 1B), with re-establishment of coronary flow (Figure 1C) although only generated by the Autopulse. The patient remained in PEA throughout, and remained Autopulse dependent after successful percutaneous coronary intervention (PCI). Transthoracic echocardiography revealed minimal left ventricular contraction, with no pericardial effusion. At this stage the ECMO team were activated. In the meantime an Impella CP (Abiomed, Danvers, MA) percutaneous ventricular assist device was inserted via a 14F femoral artery access (Figure 1D), to augment circulatory support. After a total of 105 minutes post cardiac arrest
without any spontaneous output, the patient was weaned off mechanical CPR, continuing on Impella with haemodynamic stability and supported blood pressure of around 102/ 85 mmHg. The patient was transferred to the Intensive Care Unit, and had rapidly diminishing inotropic requirements. Subsequent recovery was complicated by acute kidney injury requiring renal replacement therapy and haemothorax related to prolonged mechanical support. The patient made a full neurological recovery with no cognitive or functional deficit, and was discharged home on day 20, and back to work the following month. A cardiac MRI performed three months post MI showed, remarkably, normal left ventricular function, and no evidence of late gadolinium enhancement that indicates scarring (Figure 2).
Discussion The management of cardiogenic shock in the context of acute myocardial infarction remains a challenge, and despite advances in both pharmacological and interventional
Please cite this article in press as: Asrress KN, et al. Cardiac Arrest in Acute Myocardial Infarction: Concept of Circulatory Support With Mechanical Chest Compression and Impella to Facilitate Percutaneous Coronary Intervention. Heart, Lung and Circulation (2017), http://dx.doi.org/10.1016/j.hlc.2017.01.012
HLC 2301 No. of Pages 4
3
Figure 2 Cardiac MRI 3-months following STEMI showing no evidence of late gadolinium enhancement (A: Base, B apex of left ventricle); and normal ventricular function in the 2, 4 and 3 chamber views in diastole (C, D, E respectively) and systole (c, d, e).
therapies, mortality rates remain high [1,2]. Despite extensive investigation of multiple agents, there is a lack of clear evidence to support the use of inotropic and vasopressor therapy, and some signals towards increased mortality [3,4]. This has promoted a drive towards exploring mechanical circulatory support, with the potential benefit of providing haemodynamic support as well as myocardial protection. The intraaortic balloon pump (IABP) is widely used for a long list of indications but has yet to be shown to provide any benefit in randomised controlled trials [5,6]. The TandemHeartTM (Cardiac Assist, Pittsburgh, PA) provides mechanical circulatory support of up to 4 L/min blood with a continuous flow centrifugal pump placed in the left atrium via a transseptal puncture, to allow oxygenated blood to be aspirated and returned into the lower abdominal aorta via a femoral artery cannula [7]. However, use in the emergency setting is limited by the challenges of a fluoroscopically-guided transseptal puncture and advancement of a 21F inflow catheter into the left atrium. Extracorporeal membrane oxygenation system (ECMO) consists of a centrifugal pump, a heat exchanger and a membrane oxygenator that allows venous desaturated blood aspirated from the right atrium via the femoral vein to be oxygenated and pumped into the descending aorta via the femoral artery. ECMO has been applied in STEMI [8], and a variety of other settings, but there are no prospective randomised studies that demonstrate improved clinical outcomes. Additionally, while ECMO provides significant haemodynamic support and reduces preload, it also increases left ventricular afterload and therefore myocardial oxygen demand thereby potentially jeopardising myocardial recovery. The other issue with using ECMO emergently is that it requires a perfusionist, making it unfeasible for use in
the majority of centres, even some with on site cardiac surgery. The fourth class of percutaneous left ventricular assist devices, known as axial flow pumps, are positioned across the aortic valve and directly transfer blood from the left ventricle into the ascending aorta continuously [9]. The Impella device (Abiomed, Danvers, MA) is the most commonly used, and three products are available: the 2.5 L/min delivered via a 13F femoral arterial sheath; the CP (up to 3.5 l/min via a 14F sheath), and 5.0 L/min devices (22F). The device unloads the left ventricle directly, increasing cardiac output, reducing myocardial oxygen consumption and reducing pulmonary capillary wedge pressure. The Impella has been tested against the IABP in two clinical trials. While the Impella 2.5L was shown to provide superior haemodynamic support, this did not translate into improved clinical outcomes where equipoise between the two devices was shown [10,11]. There are no published randomised studies to date with the higher output devices. Several are underway, and there are also other devices on the horizon including the HeartMate Percutaneous Heart Pump (PHP) (St Jude Medical, Saint Paul, MN). An intriguing potential application of this device, as demonstrated in this case, is in the setting of CPR. The concept of assistance during CPR with extracorporeal membrane oxygenation (E-CPR) has been shown to have favourable clinical outcomes versus conventional CPR [12,13]. Given some of the barriers to using ECMO in many centres, as highlighted above, the extra mechanical support provided by the higher performing axial pumps such as Impella, in conjunction with automated mechanical CPR and prompt revascularisation, may provide a therapeutic option that can bridge patients to
Please cite this article in press as: Asrress KN, et al. Cardiac Arrest in Acute Myocardial Infarction: Concept of Circulatory Support With Mechanical Chest Compression and Impella to Facilitate Percutaneous Coronary Intervention. Heart, Lung and Circulation (2017), http://dx.doi.org/10.1016/j.hlc.2017.01.012
HLC 2301 No. of Pages 4
4
K.N. Asrress et al.
recovery, as highlighted in our case, or ECMO. The potential to rapidly implant these devices in the catheter laboratory with minimal extra support makes it appealing and certainly worthy of exploration in clinical studies. This paper received the Geoff Mews Fellows Prize for 2016 [13_TD$IF]0 at the Australia & New Zealand Endovascular Therapeutics (ANZET) Meeting.
[6]
[7]
[8]
Declaration There are no conflicts of interest to declare
References [1] Babaev A, Frederick PD, Pasta DJ, Every N, Sichrovsky T, Hochman JS. NRMI Investigators. Trends in management and outcomes of patients with acute myocardial infarction complicated by cardiogenic shock. JAMA 2005;294:448–54. [2] Werdan K, Gielen S, Ebelt H, Hochman JS. Mechanical circulatory support in cardiogenic shock. Eur Heart J 2014;35:156–67. [3] De Backer D, Biston P, Devriendt J, Madl C, Chochrad D, Aldecoa C, et al. SOAP II Investigators: Comparison of dopamine and norepinephrine in the treatment of shock. N Engl J Med 2010;362:779–89. [4] Mebazaa A, Nieminen MS, Packer M, Cohen-Solal A, Kleber FX, Pocock SJ, et al. SURVIVE Investigators. Levosimendan vs dobutamine for patients with acute decompensated heart failure: The SURVIVE randomized trial. JAMA 2007;297:1883–91. [5] Perera D, Stables R, Thomas M, Booth J, Pitt M, Blackman D, et al. BCIS-1 I. Elective intra-aortic balloon counterpulsation during high-risk
[9]
[10]
[11]
[12]
[13]
percutaneous coronary intervention: A randomized controlled trial. JAMA 2010;304:867–74. Patel MR, Smalling RW, Thiele H, Barnhart HX, Zhou Y, Chandra P, et al. Intra-aortic balloon counterpulsation and infarct size in patients with acute anterior myocardial infarction without shock: The CRISP AMI randomized trial. JAMA 2011;306:1329–37. Kar B, Gregoric ID, Basra SS, Idelchik GM, Loyalka P. The percutaneous ventricular assist device in severe refractory cardiogenic shock. J Am Coll Cardiol 2011;57:688–96. Sheu JJ, Tsai TH, Lee FY, Fang HY, Sun CK, Leu S, et al. Early extracorporeal membrane oxygenator-assisted primary percutaneous coronary intervention improved 30-day clinical outcomes in patients with STsegment elevation myocardial infarction complicated with profound cardiogenic shock. Crit Care Med 2010;38:1810–7. Thiele H, Smalling RW, Schuler GC. Percutaneous left ventricular assist devices in acute myocardial infarction complicated by cardiogenic shock. Eur Heart J 2007;28:2057–63. O’Neill WW, Kleiman NS, Moses J, Henriques JP, Dixon S, Massaro J, et al. A prospective, randomized clinical trial of hemodynamic support with Impella 2.5 versus intra-aortic balloon pump in patients undergoing high-risk percutaneous coronary intervention: The PROTECT II study. Circulation 2012;126:1717–27. Seyfarth M, Sibbing D, Bauer I, Fro¨hlich G, Bott-Flu¨gel L, Byrne R, et al. A randomized clinical trial to evaluate the safety and efficacy of a percutaneous left ventricular assist device versus intra-aortic balloon pumping for treatment of cardiogenic shock caused by myocardial infarction. J Am Coll Cardiol 2008;52:1584–8. Thiagarajan RR, Laussen PC, Rycus PT, Bartlett RH, Bratton SL. Extracorporeal membrane oxygenation to aid cardiopulmonary resuscitation in infants and children. Circulation 2007;116:1693–700. Chen YS, Lin JW, Yu HY, Ko WJ, Jerng JS, Chang WT, et al. Cardiopulmonary resuscitation with assisted extracorporeal life-support versus conventional cardiopulmonary resuscitation in adults with in-hospital cardiac arrest: An observational study and propensity analysis. Lancet 2008;372:554–61.
Please cite this article in press as: Asrress KN, et al. Cardiac Arrest in Acute Myocardial Infarction: Concept of Circulatory Support With Mechanical Chest Compression and Impella to Facilitate Percutaneous Coronary Intervention. Heart, Lung and Circulation (2017), http://dx.doi.org/10.1016/j.hlc.2017.01.012
BRIEF COMMUNICATION
Heart, Lung and Circulation (2017) xx, 1–4 1443-9506/04/$36.00 http://dx.doi.org/10.1016/j.hlc.2017.01.012
Cardiac Arrest in Acute Myocardial Infarction: Concept of Circulatory Support With Mechanical Chest Compression and Impella to Facilitate Percutaneous Coronary Intervention Kaleab N. Asrress, PhD a,b,c*, Maciej Marciniak, PhD a, Natalia Briceno, MBBS a, Divaka Perera, MD a a
King’s College London British Heart Foundation Centre of Excellence, The Rayne Institute, St. Thomas’ Hospital, London, England Department of Cardiology, Royal North Shore Hospital, Sydney, NSW, Australia c The Kolling Institute, Northern Clinical School, University of Sydney, Australia b
Received 3 January 2017; accepted 15 January 2017; online published-ahead-of-print xxx
Cardiogenic shock in the context of acute ST-elevation myocardial infarction (STEMI) remains a challenge to manage and results in significant mortality and morbidity, cardiac arrest in this setting even more so. The increase in myocardial oxygen demand and consumption with the use of inotropes is recognised as increasing mortality. Alternatives include the intra-aortic balloon pump (IABP), which has yet to be shown to improve outcomes, and extracorporeal membrane oxygenation (ECMO), which requires super-specialised techniques not widely available. We report a case of Anterior STEMI from a left main stem occlusion suffering with cardiac arrest on reaching the catheter laboratory table necessitating external mechanical compression with an AutopulseTM. The patient remained in pulseless electrical activity (PEA) throughout, and was Autopulse dependent despite successful percutaneous coronary intervention (PCI). An Impella1[1_TD$IF] was inserted for additional mechanical support and facilitated successful weaning from cardiopulmonary resuscitation (CPR). Despite 105 minutes without a spontaneous output, we describe the first documented case of simultaneous use of Impella with mechanical CPR with a successful outcome; demonstrating a potential technique of good mechanical haemodynamic support to aide early revascularisation that may have potential utility in the treatment of cardiogenic shock and arrest. [12_TD$IF]Keywords
Cardiac arrest Percutaneous coronary intervention Circulatory support Automated CPR
Case A 56-year-old male was brought to the cardiac catheter laboratory with anterior ST-elevation, and widespread T-wave inversion. He was transferred directly to the cardiac catheter laboratory and found to be in cardiogenic shock with a blood pressure of 80/50 mmHg, diminished consciousness
and cool peripheries. He then developed profound bradycardia and hypotension, treated with temporary transvenous right ventricular pacing. Three episodes of ventricular tachycardia and two of ventricular fibrillation were treated with direct current cardioversion to pulseless electrical activity (PEA). Initial arterial blood gas revealed a pH of 7.04. An AutopulseTM (ZOLL Medical, Chelmsford, MA) was
*Corresponding author at: Department of Cardiology, 5th Floor, Acute Services Building, Royal North Shore Hospital, Reserve Road, St Leonard’s, Sydney, NSW, 2065, Australia. Tel.: +612 9463 2506; fax: +612 9463 2053., Email: [email protected] © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.? V. All rights reserved.
Please cite this article in press as: Asrress KN, et al. Cardiac Arrest in Acute Myocardial Infarction: Concept of Circulatory Support With Mechanical Chest Compression and Impella to Facilitate Percutaneous Coronary Intervention. Heart, Lung and Circulation (2017), http://dx.doi.org/10.1016/j.hlc.2017.01.012
HLC 2301 No. of Pages 4
2
K.N. Asrress et al.
Figure 1 A: Initial coronary angiogram showing critical distal left main stem lesion (arrow) and the challenge of percutaneous intervention with mechanical CPR with several radiopaque items seen. B: Simultaneous kissing stents deployed in the left anterior descending and left circumflex into left main stem. C: Final coronary angiographic result. D: Positioning of Impella CP into left ventricle with the pigtail of catheter (bottom arrow), inflow in the left ventricular outflow tract (middle arrow) and outflow port in the ascending aorta (top arrow) during automated mechanical CPR.
positioned for ongoing mechanical cardiopulmonary resuscitation (CPR). Femoral arterial pressure of 85 mmHg with compression was achieved, and the patient was intubated and ventilated. Coronary angiography revealed an occluded left main coronary artery (LMS), with re-establishment of flow with guide catheter injection. This revealed a critical distal LMS, proximal left anterior descending (LAD) and dominant left circumflex lesions (LCx) (Figure 1A). These were treated with simultaneous kissing stents into LAD and LCx (Figure 1B), with re-establishment of coronary flow (Figure 1C) although only generated by the Autopulse. The patient remained in PEA throughout, and remained Autopulse dependent after successful percutaneous coronary intervention (PCI). Transthoracic echocardiography revealed minimal left ventricular contraction, with no pericardial effusion. At this stage the ECMO team were activated. In the meantime an Impella CP (Abiomed, Danvers, MA) percutaneous ventricular assist device was inserted via a 14F femoral artery access (Figure 1D), to augment circulatory support. After a total of 105 minutes post cardiac arrest
without any spontaneous output, the patient was weaned off mechanical CPR, continuing on Impella with haemodynamic stability and supported blood pressure of around 102/ 85 mmHg. The patient was transferred to the Intensive Care Unit, and had rapidly diminishing inotropic requirements. Subsequent recovery was complicated by acute kidney injury requiring renal replacement therapy and haemothorax related to prolonged mechanical support. The patient made a full neurological recovery with no cognitive or functional deficit, and was discharged home on day 20, and back to work the following month. A cardiac MRI performed three months post MI showed, remarkably, normal left ventricular function, and no evidence of late gadolinium enhancement that indicates scarring (Figure 2).
Discussion The management of cardiogenic shock in the context of acute myocardial infarction remains a challenge, and despite advances in both pharmacological and interventional
Please cite this article in press as: Asrress KN, et al. Cardiac Arrest in Acute Myocardial Infarction: Concept of Circulatory Support With Mechanical Chest Compression and Impella to Facilitate Percutaneous Coronary Intervention. Heart, Lung and Circulation (2017), http://dx.doi.org/10.1016/j.hlc.2017.01.012
HLC 2301 No. of Pages 4
3
Figure 2 Cardiac MRI 3-months following STEMI showing no evidence of late gadolinium enhancement (A: Base, B apex of left ventricle); and normal ventricular function in the 2, 4 and 3 chamber views in diastole (C, D, E respectively) and systole (c, d, e).
therapies, mortality rates remain high [1,2]. Despite extensive investigation of multiple agents, there is a lack of clear evidence to support the use of inotropic and vasopressor therapy, and some signals towards increased mortality [3,4]. This has promoted a drive towards exploring mechanical circulatory support, with the potential benefit of providing haemodynamic support as well as myocardial protection. The intraaortic balloon pump (IABP) is widely used for a long list of indications but has yet to be shown to provide any benefit in randomised controlled trials [5,6]. The TandemHeartTM (Cardiac Assist, Pittsburgh, PA) provides mechanical circulatory support of up to 4 L/min blood with a continuous flow centrifugal pump placed in the left atrium via a transseptal puncture, to allow oxygenated blood to be aspirated and returned into the lower abdominal aorta via a femoral artery cannula [7]. However, use in the emergency setting is limited by the challenges of a fluoroscopically-guided transseptal puncture and advancement of a 21F inflow catheter into the left atrium. Extracorporeal membrane oxygenation system (ECMO) consists of a centrifugal pump, a heat exchanger and a membrane oxygenator that allows venous desaturated blood aspirated from the right atrium via the femoral vein to be oxygenated and pumped into the descending aorta via the femoral artery. ECMO has been applied in STEMI [8], and a variety of other settings, but there are no prospective randomised studies that demonstrate improved clinical outcomes. Additionally, while ECMO provides significant haemodynamic support and reduces preload, it also increases left ventricular afterload and therefore myocardial oxygen demand thereby potentially jeopardising myocardial recovery. The other issue with using ECMO emergently is that it requires a perfusionist, making it unfeasible for use in
the majority of centres, even some with on site cardiac surgery. The fourth class of percutaneous left ventricular assist devices, known as axial flow pumps, are positioned across the aortic valve and directly transfer blood from the left ventricle into the ascending aorta continuously [9]. The Impella device (Abiomed, Danvers, MA) is the most commonly used, and three products are available: the 2.5 L/min delivered via a 13F femoral arterial sheath; the CP (up to 3.5 l/min via a 14F sheath), and 5.0 L/min devices (22F). The device unloads the left ventricle directly, increasing cardiac output, reducing myocardial oxygen consumption and reducing pulmonary capillary wedge pressure. The Impella has been tested against the IABP in two clinical trials. While the Impella 2.5L was shown to provide superior haemodynamic support, this did not translate into improved clinical outcomes where equipoise between the two devices was shown [10,11]. There are no published randomised studies to date with the higher output devices. Several are underway, and there are also other devices on the horizon including the HeartMate Percutaneous Heart Pump (PHP) (St Jude Medical, Saint Paul, MN). An intriguing potential application of this device, as demonstrated in this case, is in the setting of CPR. The concept of assistance during CPR with extracorporeal membrane oxygenation (E-CPR) has been shown to have favourable clinical outcomes versus conventional CPR [12,13]. Given some of the barriers to using ECMO in many centres, as highlighted above, the extra mechanical support provided by the higher performing axial pumps such as Impella, in conjunction with automated mechanical CPR and prompt revascularisation, may provide a therapeutic option that can bridge patients to
Please cite this article in press as: Asrress KN, et al. Cardiac Arrest in Acute Myocardial Infarction: Concept of Circulatory Support With Mechanical Chest Compression and Impella to Facilitate Percutaneous Coronary Intervention. Heart, Lung and Circulation (2017), http://dx.doi.org/10.1016/j.hlc.2017.01.012
HLC 2301 No. of Pages 4
4
K.N. Asrress et al.
recovery, as highlighted in our case, or ECMO. The potential to rapidly implant these devices in the catheter laboratory with minimal extra support makes it appealing and certainly worthy of exploration in clinical studies. This paper received the Geoff Mews Fellows Prize for 2016 [13_TD$IF]0 at the Australia & New Zealand Endovascular Therapeutics (ANZET) Meeting.
[6]
[7]
[8]
Declaration There are no conflicts of interest to declare
References [1] Babaev A, Frederick PD, Pasta DJ, Every N, Sichrovsky T, Hochman JS. NRMI Investigators. Trends in management and outcomes of patients with acute myocardial infarction complicated by cardiogenic shock. JAMA 2005;294:448–54. [2] Werdan K, Gielen S, Ebelt H, Hochman JS. Mechanical circulatory support in cardiogenic shock. Eur Heart J 2014;35:156–67. [3] De Backer D, Biston P, Devriendt J, Madl C, Chochrad D, Aldecoa C, et al. SOAP II Investigators: Comparison of dopamine and norepinephrine in the treatment of shock. N Engl J Med 2010;362:779–89. [4] Mebazaa A, Nieminen MS, Packer M, Cohen-Solal A, Kleber FX, Pocock SJ, et al. SURVIVE Investigators. Levosimendan vs dobutamine for patients with acute decompensated heart failure: The SURVIVE randomized trial. JAMA 2007;297:1883–91. [5] Perera D, Stables R, Thomas M, Booth J, Pitt M, Blackman D, et al. BCIS-1 I. Elective intra-aortic balloon counterpulsation during high-risk
[9]
[10]
[11]
[12]
[13]
percutaneous coronary intervention: A randomized controlled trial. JAMA 2010;304:867–74. Patel MR, Smalling RW, Thiele H, Barnhart HX, Zhou Y, Chandra P, et al. Intra-aortic balloon counterpulsation and infarct size in patients with acute anterior myocardial infarction without shock: The CRISP AMI randomized trial. JAMA 2011;306:1329–37. Kar B, Gregoric ID, Basra SS, Idelchik GM, Loyalka P. The percutaneous ventricular assist device in severe refractory cardiogenic shock. J Am Coll Cardiol 2011;57:688–96. Sheu JJ, Tsai TH, Lee FY, Fang HY, Sun CK, Leu S, et al. Early extracorporeal membrane oxygenator-assisted primary percutaneous coronary intervention improved 30-day clinical outcomes in patients with STsegment elevation myocardial infarction complicated with profound cardiogenic shock. Crit Care Med 2010;38:1810–7. Thiele H, Smalling RW, Schuler GC. Percutaneous left ventricular assist devices in acute myocardial infarction complicated by cardiogenic shock. Eur Heart J 2007;28:2057–63. O’Neill WW, Kleiman NS, Moses J, Henriques JP, Dixon S, Massaro J, et al. A prospective, randomized clinical trial of hemodynamic support with Impella 2.5 versus intra-aortic balloon pump in patients undergoing high-risk percutaneous coronary intervention: The PROTECT II study. Circulation 2012;126:1717–27. Seyfarth M, Sibbing D, Bauer I, Fro¨hlich G, Bott-Flu¨gel L, Byrne R, et al. A randomized clinical trial to evaluate the safety and efficacy of a percutaneous left ventricular assist device versus intra-aortic balloon pumping for treatment of cardiogenic shock caused by myocardial infarction. J Am Coll Cardiol 2008;52:1584–8. Thiagarajan RR, Laussen PC, Rycus PT, Bartlett RH, Bratton SL. Extracorporeal membrane oxygenation to aid cardiopulmonary resuscitation in infants and children. Circulation 2007;116:1693–700. Chen YS, Lin JW, Yu HY, Ko WJ, Jerng JS, Chang WT, et al. Cardiopulmonary resuscitation with assisted extracorporeal life-support versus conventional cardiopulmonary resuscitation in adults with in-hospital cardiac arrest: An observational study and propensity analysis. Lancet 2008;372:554–61.
Please cite this article in press as: Asrress KN, et al. Cardiac Arrest in Acute Myocardial Infarction: Concept of Circulatory Support With Mechanical Chest Compression and Impella to Facilitate Percutaneous Coronary Intervention. Heart, Lung and Circulation (2017), http://dx.doi.org/10.1016/j.hlc.2017.01.012