The Impella Device as a Temporary Bridge for Acute Mechanical Circulatory Support

Abstract

The mortality rate from cardiogenic shock after acute myocardialinfarction (MI) is high without reperfusion (70%-80%) [1]. Early revascularization is the basis of treatment of acute MI complicated by cardiogenic shock. Mechanical circulatory devices provide additional support for patients with refractory cardiogenic shock after revascularization alone has failed. These devices have been shown in the literature to improve outcomes in contrast to pharmacologic agents and/or intra-aortic balloon pump (IABP) demonstrated in the literature [2]. Short-term ventricular assists devices (VADs) can be initiated quickly and do not necessarily require a sternotomy. The Impella devices are minimally invasively placed, catheter mounted microaxial flow pumps. They are designed to directly unload the left ventricle, reduce myocardial workload and oxygen consumption while increasing cardiac output, coronary and end-organ perfusion. The purpose of our study is to review a patient who presented with acute cardiogenic shock and was treated with an Impella 5.0 device for temporarymechanical support.