Impact of Impella Support on Clinical Outcomes in Patients with Postcardiotomy Cardiogenic Shock.

IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Yukiharu Sugimura, Moritz Benjamin Immohr, Arash Mehdiani, Udo Boeken, Hug Aubin, Artur Lichtenberg, Payam Akhyari
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Abstract

Purpose: This study aimed to elucidate the strategy of an effective Impella support for better clinical outcomes in patients with a postcardiotomy cardiogenic shock (PCCS).

Methods: This single-center retrospective observational study enrolled 31 patients with PCCS undergoing an elective open-heart surgery followed by Impella support between November 2018 and February 2022 for further analysis.

Results: The preoperative Euroscore II and left ventricular (LV) ejection fraction were 9.1 ± 10.4 and 35.7% ± 12.6%, respectively. The in-hospital mortality rate was 51.6% (n = 16). In survivors (n = 15), the mean Impella support time was 6.9 ± 3.5 days. Patients were discharged on the postoperative day 24.9 ± 16.4. Regarding LV remodeling, LV end-diastolic diameter was significantly decreased after Impella support (59.2 ± 6.0 mm vs. 54.4 ± 4.7 mm, p = 0.01, preoperative vs. postoperative). In-hospital mortality rates were comparable with small (CP, n = 6) or large (5.0, n = 25) Impella systems (33.3% [n = 2] vs. 56.0% [n = 14], p = 0.39). However, a lower in-hospital mortality rate was observed in the group with early initiation (i.e., intraoperative) of Impella support (n = 14) than that with delayed Impella initiation (i.e., in the postoperative course) (n = 11) (28.6% [n = 4] vs. 90.9% [n = 10], p = 0.004).

Conclusions: Impella support contributes to LV remodeling in PCCS patients. In-hospital mortality was comparable in different Impella sizes and lower in early Impella initiation.

Impella 支持对心肌梗死术后心源性休克患者临床疗效的影响。
目的:本研究旨在阐明有效的Impella支持策略,以改善心肌梗死术后心源性休克(PCCS)患者的临床预后:这项单中心回顾性观察研究纳入了2018年11月至2022年2月间接受择期开胸手术并接受Impella支持的31例PCCS患者,并进行了进一步分析:术前Euroscore II和左心室射血分数分别为9.1±10.4和35.7%±12.6%。院内死亡率为 51.6%(16 人)。幸存者(n = 15)的平均Impella支持时间为(6.9 ± 3.5)天。患者于术后第 24.9 ± 16.4 天出院。在左心室重塑方面,Impella支持后左心室舒张末期直径明显缩小(59.2 ± 6.0 mm vs. 54.4 ± 4.7 mm,p = 0.01,术前 vs. 术后)。小型(CP,n = 6)或大型(5.0,n = 25)Impella 系统的院内死亡率相当(33.3% [n = 2] vs. 56.0% [n = 14],p = 0.39)。然而,早期启动(即术中)Impella 支持系统组(n = 14)的院内死亡率低于延迟启动(即术后)Impella 支持系统组(n = 11)(28.6% [n = 4] vs. 90.9% [n = 10],p = 0.004):结论:Impella支持有助于PCCS患者的左心室重塑。结论:Impella支持有助于PCCS患者的左心室重塑。不同Impella大小的患者的院内死亡率相当,而早期Impella启动的患者死亡率较低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Thoracic and Cardiovascular Surgery
Annals of Thoracic and Cardiovascular Surgery CARDIAC & CARDIOVASCULAR SYSTEMS-SURGERY
CiteScore
2.80
自引率
0.00%
发文量
56
审稿时长
4-8 weeks
期刊介绍: Information not localized
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