Journal of the Society for Cardiovascular Angiography & Interventions最新文献

{"title":"Utilization of Preventive Single-Inflow Cannula Left Atrial Veno-Arterial Extracorporeal Membrane Oxygenation in Cardiogenic Shock","authors":"Yu-Tsung Shih PhD,&nbsp;Hung-Chang Jong MD,&nbsp;Chia-Cheng Lin MS,&nbsp;Bu-Yuan Hsiao MD, MS,&nbsp;Chung-Ming Tu MD,&nbsp;Jung-Cheng Hsu MD,&nbsp;Ta-Jung Wang MD, PhD","doi":"10.1016/j.jscai.2026.105518","DOIUrl":"10.1016/j.jscai.2026.105518","url":null,"abstract":"<div><h3>Background</h3><div>Left ventricular/left ventricle (LV) overload remains a major limitation of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in patients with cardiogenic shock. Left atrial veno-arterial extracorporeal membrane oxygenation (LAVA-ECMO) has been proposed to facilitate LV unloading; however, data regarding its optimal timing and clinical role remain limited.</div></div><div><h3>Methods</h3><div>This single-center retrospective cohort study evaluated the efficacy and safety of a preventive single-inflow cannula LAVA-ECMO strategy, defined as an a priori LV unloading approach implemented at extracorporeal membrane oxygenation (ECMO) initiation, either through primary LAVA-ECMO implantation or planned early conversion from VA-ECMO within 60 minutes. Between January 2020 and July 2025, eligible patients supported with VA-ECMO or LAVA-ECMO were screened. After predefined exclusions, 42 patients managed with preventive LAVA-ECMO were compared with 64 contemporaneous patients receiving conventional VA-ECMO.</div></div><div><h3>Results</h3><div>Thirty-day all-cause mortality was lower in the LAVA-ECMO group than in the VA-ECMO group (47.6% vs 76.6%; adjusted hazard ratio, 0.54; 95% CI, 0.31-0.95). Failure to wean from ECMO tended to occur less frequently with LAVA-ECMO (31.0% vs 56.3%; adjusted odds ratio, 0.43; 95% CI, 0.18-1.01). Signs of LV overload during ECMO support were significantly reduced in the LAVA-ECMO group (47.6% vs 82.8%; adjusted odds ratio, 0.19, 95% CI, 0.08-0.49). Overall complication rates were comparable between groups.</div></div><div><h3>Conclusions</h3><div>In this retrospective cohort, preventive LAVA-ECMO was associated with lower short-term mortality and a reduced incidence of LV overload without an apparent increase in complications. Preventive LAVA-ECMO may represent a feasible mechanical circulatory support strategy in carefully selected patients with cardiogenic shock.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 10","pages":"Article 105518"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149222304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraprocedural Angiographic Lung Perfusion: A Novel Application for Real-Time Integration Into a Fluoroscopic Platform","authors":"Arash Salavitabar MD,&nbsp;Daniel Gruenstein MD,&nbsp;Chance Alvarado MS,&nbsp;Andrew Kuhls-Gilcrist PhD,&nbsp;Gurumurthy Hiremath MD","doi":"10.1016/j.jscai.2026.105617","DOIUrl":"10.1016/j.jscai.2026.105617","url":null,"abstract":"<div><h3>Background</h3><div>Assessment of differential lung perfusion is currently limited to periprocedural lung perfusion scans (LPS) or magnetic resonance imaging (MRI), which do not enable for real-time decision making. This study demonstrates the development and evaluation of a novel angiographic lung perfusion (ALP) technique in patients with congenital heart disease.</div></div><div><h3>Methods</h3><div>The ALP technique was used to analyze differential branch pulmonary artery (PA) flow in retrospectively identified PA angiograms with corresponding LPS or MRI. Intraclass correlation coefficient and agreement were assessed. Two mathematical models were tested (area under curve and slope) at 2 time points (second peak and average).</div></div><div><h3>Results</h3><div>Twenty-five angiograms were analyzed. The most common cardiac anatomy was tetralogy of Fallot, and most common indication for catheterization was unilateral branch PA stenosis. The slope-based methods demonstrated high intraclass correlation coefficients with LPS/MRI (ICC, 0.84-0.86), indicating good reliability (ranging moderate-to-excellent), whereas Bland-Altman analysis showed low overall bias.</div></div><div><h3>Conclusions</h3><div>This ALP quantification application enables accurate lung perfusion assessment with potential for real-time integration into a fluoroscopic platform. This method provides a potential method for quantifying clinically meaningful intraprocedural information, particularly in assessing relative changes in differential perfusion before and after PA interventions. Further prospective studies are needed to confirm accuracy and clinical utility in broader populations.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 10","pages":"Article 105617"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149222312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Covered Stent Fenestration for Side Branch Salvage in Bifurcation Coronary Perforation: A Systematic Bench-Test Evaluation","authors":"Troels Yndigegn MD, PhD,&nbsp;Per Bondesson MD,&nbsp;Göran K. Olivecrona MD, PhD,&nbsp;Henrik Wagner MD, PhD,&nbsp;Sasha Koul MD, PhD,&nbsp;Matthias Götberg MD, PhD,&nbsp;Helle Soeholm MD, PhD,&nbsp;David Erlinge MD, PhD,&nbsp;Mihai Cocoi MD,&nbsp;Olivier Gach MD, PhD,&nbsp;Adrien Jossart MD,&nbsp;Quentin Trefois MD,&nbsp;Agostino Spano MD,&nbsp;Giuseppe Colletti MD,&nbsp;Gregor Leibundgut MD,&nbsp;Marouane Boukhris MD,&nbsp;Claudiu Ungureanu MD,&nbsp;Moman A. Mohammad MD, PhD","doi":"10.1016/j.jscai.2026.105521","DOIUrl":"10.1016/j.jscai.2026.105521","url":null,"abstract":"<div><h3>Background</h3><div>Coronary perforation at a bifurcation level is a life-threatening emergency. Covered stents may seal the defect but risk side-branch occlusion. We evaluated the feasibility and technical considerations of guide wire fenestration at coronary bifurcations and present a case where a covered side branch was successfully salvaged.</div></div><div><h3>Methods</h3><div>A transparent bifurcation phantom replicating coronary anatomy was constructed and integrated into a pulsatile flow system. Three fenestration strategies were evaluated: (1) a balloon-blocking approach, in which inflation of a balloon in the main branch after covered stent deployment was hypothesized to facilitate wire redirection and fenestration; (2) a microcatheter-assisted approach; and (3) a wire-only approach. These strategies were tested by 15 percutaneous coronary intervention operators with varying levels of experience. Seven guide wires with differing characteristics and tip loads ranging from 3 to 12 g were used.</div></div><div><h3>Results</h3><div>The balloon occlusion strategy achieved fenestration in all tests (n = 15) using both 12 g and 3 g wires, as did microcatheter-assisted fenestrations (n = 2). Wire-only strategy succeeded in 14 of 17 attempts across wires ranging from 3 to 12 g; however, 3 of 6 attempts using 3 g wires required conversion to balloon occlusion. Median time to fenestration was 69 seconds for both balloon occlusion and microcatheter strategies, compared with 81 seconds, 94 seconds, and 167 seconds for wire-only approaches using 12 g, 6 g, and 3 g wires, respectively. Angiography and micro–computed tomography demonstrated satisfactory results, but endoscopic analysis revealed polyurethane membrane recoil reducing the ostial area by up to 75%, necessitating side-branch stenting. All evaluated side-branch stenting techniques improved the ostial lumen area.</div></div><div><h3>Conclusions</h3><div>Covered stent fenestration is a feasible bailout strategy for preserving side-branch patency in critical bifurcation perforations.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 10","pages":"Article 105521"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149222271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Concurrent Impella-Assisted High-Risk PCI and TAVR in Patients With Complex Coronary Artery Disease and Severe Aortic Stenosis","authors":"Frederick Berro Rivera MD,&nbsp;Brenden Ingraham MD,&nbsp;Pietro Di Santo MD, PhD,&nbsp;Trevor Simard MD, PhD,&nbsp;Benjamin Hibbert MD, PhD,&nbsp;Mandeep Singh MD, MPH","doi":"10.1016/j.jscai.2026.105562","DOIUrl":"10.1016/j.jscai.2026.105562","url":null,"abstract":"<div><h3>Background</h3><div>Percutaneous management of high risk, percutaneous coronary intervention (PCI) needing mechanical support for complex coronary artery disease in patients needing transcatheter aortic valve replacement for severe aortic stenosis remains incompletely defined. We report on the feasibility and safety of a single-session strategy using Impella-assisted complex high-risk PCI (IA-CHIP) followed by transcatheter aortic valve replacement (TAVR).</div></div><div><h3>Methods</h3><div>We conducted a multicenter retrospective study of consecutive patients undergoing simultaneous IA-CHIP and TAVR at 3 tertiary centers between January 2015 and March 2026. All patients received mechanical circulatory support with percutaneous microaxial flow pump Impella CP (Abiomed) during PCI, followed by transfemoral TAVR in the same session. Baseline demographics, procedural characteristics, and clinical outcomes were collected. The primary endpoint was in-hospital complications, including death, stroke, major bleeding (Bleeding Academic Research Consortium types 2, 3, or 5), acute kidney injury, permanent pacemaker implantation, and vascular complications.</div></div><div><h3>Results</h3><div>A total of 12 patients were included (median age, 79.5 years [IQR, 77.0-81.2]; 91.7% male; median Charlson Comorbidity Index of 7 [IQR, 5.8-9]). Coronary lesions mainly involved left main disease in 66% of cases. Advanced calcium modification was required in 50% of cases. The median aortic valve area was 0.86 cm², and median mean gradient was 38 mm Hg. Procedural success for IA-CHIP and TAVR was 100%. There were no in-hospital deaths, strokes, or major vascular complications. Conduction disturbances requiring permanent pacemaker implantation occurred in 25%. An acute kidney injury occurred in 16.7% of cases, with no requirement for dialysis. The majority of patients (91.7%) were discharged home.</div></div><div><h3>Conclusions</h3><div>A single-session strategy of IA-CHIP followed by TAVR is feasible and safe in selected patients with complex coronary artery disease and severe aortic stenosis.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 10","pages":"Article 105562"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149222274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Management of a Large Isolated Systemic to Pulmonary Artery Collateral (Type B Malinosculation) in a 13-Year-Old: A Case Report","authors":"Meghal Sancheti DO,&nbsp;Saif Rehman MD,&nbsp;Alexander V. Chalphin MD,&nbsp;Matthew Bramlet MD,&nbsp;Boban P. Abraham MD","doi":"10.1016/j.jscai.2026.105576","DOIUrl":"10.1016/j.jscai.2026.105576","url":null,"abstract":"<div><div>Type B malinosculation is a rare congenital malformation and a substrate for left-to-right shunting. We discuss a case of a 13-year-old boy with left-heart enlargement and incidental finding of a large isolated systemic arterial collateral to normal left lower lung. After review of computed tomography angiography of chest and risk-benefit assessment, the patient underwent transcatheter occlusion. This case highlights the importance of investigating aortopulmonary collaterals as an etiology for unexplained left-heart volume overload. We also discuss different treatment strategies used in this rare condition.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 10","pages":"Article 105576"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149222313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in Referral Timing for Mitral Transcatheter Edge-to-Edge Repair: A Retrospective Cohort Study","authors":"Saliha Erdem MD,&nbsp;Anas Hashem MD,&nbsp;Chloe Kharsa MD,&nbsp;Mangesh Kritya MD,&nbsp;Abou Zeid Karl MD,&nbsp;Nadeen Faza MD,&nbsp;Martha Gulati MD, MS","doi":"10.1016/j.jscai.2026.105618","DOIUrl":"10.1016/j.jscai.2026.105618","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 10","pages":"Article 105618"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149222309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrosurgical Septal Leaflet Liberation and Transcatheter Tricuspid Valve Replacement for Failed Postero-Septal Tricuspid Transcatheter Edge-to-Edge Repair","authors":"Smitha Narayana Gowda MBBS,&nbsp;Ratnasari Padang MBBS, PhD,&nbsp;Mackram F. Eleid MD","doi":"10.1016/j.jscai.2026.105570","DOIUrl":"10.1016/j.jscai.2026.105570","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 9","pages":"Article 105570"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Matched and Measured: An In-depth Look at the Interventional Cardiology Fellowship Match—Fellows’ Perspective","authors":"Naseer A. Khan MD,&nbsp;Najam U. Saqib MD,&nbsp;Eva Meunier TAGME,&nbsp;Dean J. Kereiakes MD,&nbsp;Luay Alalawi MD,&nbsp;Said Hajouli MD,&nbsp;Muhammad Saleem MD,&nbsp;Abubakar Nazir MD","doi":"10.1016/j.jscai.2026.105454","DOIUrl":"10.1016/j.jscai.2026.105454","url":null,"abstract":"<div><h3>Background</h3><div>In July 2024, the interventional cardiology (IC) fellowship match transitioned to the National Resident Matching Program (NRMP) to streamline recruitment and ensure transparency. Our prior analysis explored the program directors’ (PDs) experiences, revealing positive perceptions despite initial concerns. This current study addresses a critical limitation of the previous work by incorporating the applicants’ perspective. The aim of this study is to investigate perceptions of fellows who participated in the IC fellowship for the NRMP match cycles.</div></div><div><h3>Methods</h3><div>This descriptive study utilized data from publicly available NRMP and Electronic Residency Application Services along with our survey to evaluate the IC fellowship match from the fellows’ perspective. An anonymous online survey was distributed to fellows to gather quantitative and qualitative data. Survey topics included questions about interviews, ranking, and factors influencing rank lists, and satisfaction with the new match system.</div></div><div><h3>Results</h3><div>An anonymous national fellow survey was completed by 38% (N = 96) of IC fellows, most of whom were applicants to the 2026-2027 IC fellowship match. Seventy percent applied to &gt;30 programs, with the majority receiving &gt;15 invitations. Rank list depth varied, although most applicants ranked multiple programs, most commonly 6 to 10 (30%) or &gt;15 (28%). Prematch offers were rare (13%), and 78% of applicants preferred training at external institutions, whereas the majority preferred virtual interviews. Qualitative responses emphasized procedural volume, program reputation, mentorship, and culture as key drivers of ranking decisions, whereas challenges included limited program information, inconsistent communication, uncertainty around prematch activity, and stress.</div></div><div><h3>Conclusions</h3><div>The transition to the NRMP match for IC fellowships presented both successes and challenges from the fellows’ viewpoint, complementing the PDs’ perspectives documented previously. Our study helps highlight challenges in future IC match.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 9","pages":"Article 105454"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized Evaluation of a Textile-Based Enhanced Radiation Protection Device Versus Control Shielding in the Cardiac Catheterization Laboratory","authors":"Oskar Angerås MD, PhD,&nbsp;Pernilla I. Jonasson MSc,&nbsp;Christian Dworeck MD, PhD,&nbsp;Gunilla Friberg RN, MSc,&nbsp;Dan Ioanes MD,&nbsp;Antros Louca MD, PhD,&nbsp;Jacob Odenstedt MD, PhD,&nbsp;Petur Petursson MD, PhD,&nbsp;Björn Redfors MD, PhD,&nbsp;Petronella Torild RN, MSc,&nbsp;Fanny Töpel RN,&nbsp;Maria E.V. Larsson MSc, PhD,&nbsp;Truls Råmunddal MD, PhD","doi":"10.1016/j.jscai.2026.105523","DOIUrl":"10.1016/j.jscai.2026.105523","url":null,"abstract":"<div><h3>Background</h3><div>Occupational radiation exposure remains an inherent risk in cardiac catheterization laboratories. Conventional radiation protection relies on ceiling- and table-mounted shields combined with wearable lead-equivalent personal protective equipment, yet exposure persists and ergonomic burden remains substantial. Enhanced radiation protection devices (ERPD) aim to attenuate scatter radiation at the patient level, but randomized evaluations using comprehensive dosimetry are limited.</div></div><div><h3>Methods</h3><div>In this prospective, single-center, cluster-randomized study, shielding strategies were alternated by week (6 ERPD vs 6 control weeks). A textile-based ERPD (Texray MasterPeace™) was compared with control shielding. Occupational radiation exposure to the first operator and scrub nurse was assessed using a 69-point thermoluminescent dosimetry array worn over personal protective equipment, capturing deep dose equivalent (Hp(10) for operator and scrub nurse roles. The primary end point was weekly cumulative Hp(10) normalized to patient radiation output. Secondary analyses included spatial dose distribution and accumulated Hp(10) over the study period.</div></div><div><h3>Results</h3><div>A total of 190 procedures were included (ERPD n = 90; control n = 100). Baseline procedural characteristics, including dose area product and fluoroscopy time, were similar between groups. Mean weekly operator Hp(10) was 0.11 mSv with conventional shielding and 0.02 mSv with ERPD (mean difference −0.083 mSv; 95% CI −0.106 to −0.061; <em>P</em> &lt; .001), corresponding to an 78% relative reduction. Scrub nurse exposure was similarly reduced (0.06 vs 0.01 mSv; 77% reduction). Findings were consistent with reductions across all anatomical regions.</div></div><div><h3>Conclusions</h3><div>In a randomized real-world setting, MasterPeace ERPD substantially reduced occupational radiation exposure for both operators and scrub nurses, supporting its use as an adjunct to conventional shielding.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 9","pages":"Article 105523"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics and Outcomes of Cardiogenic Shock in Acute Myocarditis Versus Takotsubo Cardiomyopathy: A Propensity Matched Nationwide Analysis","authors":"Hossam Ibrahim MD,&nbsp;Oluchi Ndulue MBBS,&nbsp;Fatmaelzahraa Badr MD,&nbsp;Valentine C. Nriagu MD, MPH,&nbsp;Hasan Alarouri MBBS,&nbsp;Armando Seitllari MD,&nbsp;Binit Aryal MBBS,&nbsp;Supraja Achuthanandan MD,&nbsp;Steven Sorci DO,&nbsp;Bilal Malik MD,&nbsp;Gerald Hollander MD,&nbsp;Robert Frankel MD,&nbsp;Jacob Shani MD,&nbsp;Vijay Shetty MD, MBA","doi":"10.1016/j.jscai.2026.105460","DOIUrl":"10.1016/j.jscai.2026.105460","url":null,"abstract":"<div><h3>Background</h3><div>Cardiogenic shock (CS) is a life-threatening complication of acute myocarditis (MC) and takotsubo cardiomyopathy (TC). Comparative data on mechanical circulatory support (MCS) utilization and outcomes between these cohorts remain undefined.</div></div><div><h3>Methods</h3><div>Using the National Inpatient Sample 2020-2022 database, adult hospitalizations with concomitant diagnoses of CS and MC (MC-CS) or TC (TC-CS) were identified. Patients with cardiac arrest, acute coronary syndrome, coronary revascularization, or incomplete records were excluded. A 1:1 propensity score match was performed to balance demographics, baseline comorbidities, and hospital characteristics. The primary outcome was in-hospital mortality. Secondary outcomes included MCS and resource utilization.</div></div><div><h3>Results</h3><div>Among 7080 hospitalizations (MC-CS: n = 2825; TC-CS: n = 4255), patients with MC-CS were younger (46.5 vs 62.9 years) and predominantly male (58.0% vs 27.5%). Propensity score matching yielded 2435 balanced pairs. In the matched cohort, hospital mortality (26.5% vs 26.7%; <em>P</em> = .97) and length of stay (16.2 vs 16.0 days; <em>P</em> = .96) were comparable between groups. MC-CS was associated with higher use of temporary MCS (30.0% vs 10.5%; <em>P</em> &lt; .001), including extracorporeal membrane oxygenation (14.2% vs 2.3%, <em>P</em> = .003), Impella (14.6% vs 6.8%, <em>P</em> = .04), and intra-aortic balloon pump (13.6% vs 3.1%, <em>P</em> = .003). Total hospital charges were higher for MC-CS ($435,121 vs $288,522; <em>P</em> = .008).</div></div><div><h3>Conclusions</h3><div>In patients with CS, hospital mortality and length of stay are comparable between MC-CS and TC-CS when matched for baseline clinical risk. However, MC-CS involves nearly 3-fold higher utilization of MCS alongside higher hospital charges.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 9","pages":"Article 105460"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}