Why the study?
Emergent repair of post-infarct VSD is challenging, and there remains no standard for achieving hemodynamic stability, including the usage and mode of temporary mechanical circulatory support.
Can Impella 5.5 provide extended hemodynamic support as a bridge to surgical repair in a patient with post-infarct VSD and cardiogenic shock?
Can Impella 5.5 provide extended hemodynamic support as a bridge to surgical repair in a patient with post-infarct VSD and cardiogenic shock?
Extended use of Impella 5.5 can successfully provide hemodynamic stability as a bridge to delayed surgical repair in post-infarct VSD with cardiogenic shock.
Answers are grounded in this paper and cite their sources.
Axillary Impella 5.5 may bridge select post-infarct VSD patients to delayed repair; leaves open optimal MCS strategy and timing.
Post-infarct ventricular septal defect (VSD) carries high mortality. Since emergent repair of post-infarct VSD is challenging, hemodynamic stabilization utilizing temporary mechanical circulatory support crucially provides time to delay intervention and allows necessary scar tissue formation which improves the fragility of myocardium and leads to a definitive repair. To date, there remains no standard for achieving hemodynamic stability, including usage and mode of temporary mechanical circulatory support. We describe a patient with acute post-infarct VSD in cardiogenic shock successfully supported with Impella 5.5 for 67 days as a bridge to surgical repair and coronary artery bypass grafting.
No takes yet. Share an insight, caveat, or question.
Gregory et al. (2024) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: