Cardiogenic shock: From ECMO to Impella and beyond

Mehdi H Shishehbor; Nader Moazami; Michael Zhen-Yu Tong; Shinya Unai; W H Wilson Tang; Edward G Soltesz

doi:10.3949/ccjm.84gr.17002

Cardiogenic shock: From ECMO to Impella and beyond

Cleve Clin J Med. 2017 Apr;84(4):287-295. doi: 10.3949/ccjm.84gr.17002.

Authors

Mehdi H Shishehbor¹, Nader Moazami^{2

3}, Michael Zhen-Yu Tong⁴, Shinya Unai⁵, W H Wilson Tang^{6

3}, Edward G Soltesz^{4

7

8}

Affiliations

¹ Medical Director, Endovascular Services, Department of Cardiovascular Medicine, and Associate Program Director, Interventional Cardiology, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA. shishem@ccf.org.
² Surgical Director, Heart Failure, Heart/Cardiac TX and Mechanical Circulatory Support, Heart and Vascular institute, and Biomedical Engineering, Cleveland Clinic;, Cleveland, OH, USA.
³ Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
⁴ Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, USA.
⁵ Clinical Associate, Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, USA.
⁶ Center for Clinical Genomics, Department of Cardiovascular Medicine, Department of Cellular and Molecular Medicine, Genomic Medicine Institute, Critical Care Center, and Transplantation Center, Cleveland Clinic, Cleveland, OH, USA.
⁷ Director, Cardiac Surgery Affiliate Programs, Cleveland Clinic, Cleveland, OH, USA.
⁸ Program Director, Residency and Fellowship Program, Cleveland Clinic, Cleveland, OH, USA.

PMID: 28388392
DOI: 10.3949/ccjm.84gr.17002

Abstract

For patients in cardiogenic shock, several devices can serve as a "bridge," ie, provide circulatory support and allow the patient to live long enough to recover or to receive a heart transplant or a long-term device. Options include an intra-aortic balloon pump, TandemHeart, Impella, extracorporeal membrane oxygenation (ECMO), and CentriMag. Which device to use depends on individual patient needs, local expertise, and anatomic and physiologic considerations.

Publication types

Case Reports
Review

MeSH terms

Adult
Anti-Arrhythmia Agents / therapeutic use
Cardiotonic Agents / therapeutic use
Clinical Decision-Making
Extracorporeal Membrane Oxygenation*
Heart-Assist Devices*
Humans
Intra-Aortic Balloon Pumping*
Male
Severity of Illness Index
Shock, Cardiogenic / etiology
Shock, Cardiogenic / therapy*
Stroke Volume
Ventricular Dysfunction, Left / complications
Ventricular Dysfunction, Left / physiopathology
Ventricular Dysfunction, Left / therapy*

Substances

Anti-Arrhythmia Agents
Cardiotonic Agents