Why the study?
Does Impella improve hemodynamics compared to ECMO in patients with AMI-VSD?
Does Impella improve hemodynamics compared to ECMO in patients with AMI-VSD?
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Based on hemodynamics alone, Impella provides the optimal form of percutaneous mechanical circulatory support in AMI-VSD by improving pulmonary capillary wedge pressure and shunting, whereas ECMO worsens these parameters.
Although no form of percutaneous MCS normalized hemodynamics in AMI-VSD, pulmonary capillary wedge pressure and shunting were worsened by extracorporeal membrane oxygenation and improved by Impella. Accordingly, based on hemodynamics alone, Impella provides the optimal form of support in AMI-VSD. However, other factors, including team experience, device availability, potential for tissue ingestion, and clinical characteristics, need to be considered when choosing a percutaneous MCS device for AMI-VSD.
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Pahuja et al. (2019) studied this question.
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