Impella 2.5 support during high-risk PCI in 6 patients with AMI and acute heart failure was feasible, with 4 patients showing hemodynamic improvement up to 12 months and 2 deaths.
Case Report (n=6)
Does Impella 2.5 improve prognosis in patients undergoing high-risk PCI after AMI with very low ejection fraction and acute heart failure?
Impella 2.5 support is feasible during high-risk PCI for patients with AMI complicated by acute heart failure and low ejection fraction.
BACKGROUND: Acute myocardial infarction (AMI) complicated by cardiogenic shock (AMI-CS) or heart failure is associated with an unacceptably high in-hospital mortality of 33%-55% and a lost chance to accept PCI (Percutaneous Coronary Intervention). AIM: The aim of the study was to find out whether percutaneous hemodynamic support device Impella 2.5 improves prognosis of high-risk PCI patients or not. METHODS: This study was a case series involving six patients who underwent a Left Ventricular Assist Device (LVAD, Impella 2.5, Abiomed, Danvers, MA) implantation after suffering from AMI with a very low ejection fraction and acute heart failure. The clinical experience and outcomes of the patients are hereby discussed. RESULTS: All PCI procedures were safely completed under LVAD support. The hemodynamic parameters of all patients improved clinically over the next 30 days and following 12 months after Impella insertion except in two patients, of which one patient (Case number 6) died 4 days post-Impella protected PCI procedure due to acute left ventricle heart failure with cardiogenic shock and pulmonary oedema; and another one died at 12 months after Impella protected PCI procedure (Case number 4) due to decompensated heart failure and infected pneumonia. CONCLUSION: Percutaneous hemodynamic support is favorable and feasible during high risk Percutaneous Coronary Intervention (PCI). A bigger study is needed to substantiate the claims of the current study.
Bhat et al. (Tue,) conducted a case report in Acute myocardial infarction complicated by acute heart failure and very low ejection fraction (n=6). Impella 2.5 was evaluated on Hemodynamic improvement and mortality. Impella 2.5 support during high-risk PCI in 6 patients with AMI and acute heart failure was feasible, with 4 patients showing hemodynamic improvement up to 12 months and 2 deaths.
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