The impella micro-axial flow catheter is safe and effective for treatment myocarditis complicated by cardiogenic shock: An analysis from the global cVA registry
Kapur NK, Esposito M, Kuchibhotla S, Hall S, Schreiber T, O'Neill W. The impella micro-axial flow catheter is safe and effective for treatment myocarditis complicated by cardiogenic shock: An analysis from the global cVA registry. J Card Fail. 2017;23(8):S130-S131.
J Card Fail
Background: Myocarditis complicated by cardiogenicshock (Myo-CS) remain complex clinical problem. Theuse of acute mechanical circulatory support devices cardiogenic shock is growing. We explored theclinical utility of Impella tra valvular micro-axial flowcatheters in the setting of Myo-CS. Methods: We retrospectiv analyzed data from 21 sites within thecVAD registry, an ongoing multicenter volu tary registry at sites in North America and Europe that have used Impella in >10 patien Myocarditis was defined by endomyocardial biopsy in 34% (n= 11) or by clinical hist without angiographic evidence of coronary disease (n = 23). Results: A total of 34 tients who received Impella support for Myo-CS were identified. Mean age was 42 ± years with 17 males. Baseline mean cardiac index was 1.8 ± 0.5 L·min-1·m-2, pulm nary capillary wedge pressure was 25 ± 7 mmHg, and right atrial pressure w 22 ± 3 mmHg. Mean lactate was 27 ± 31 mg·dL-1. 32% (n= 11) of patients required intra-aortic balloon pump and 85% (n = 29) were requiring vasopressor/inotrope therapy prior to Impella placement. The Impella 2.5, CP, and 5.0 were used in 41% (n = 14), 35% (n = 12) and 24% (n = 8) respectively. Impella support was used for a mean duration of 90.56 ± 74.26 hours. Mean left ventricular ejection fraction improved fromadmission to discharge (18 ± 10 vs 37 ± 20%, P = .001). In-hospital mortality was 38% (n = 13), 47% (n = 16) of patients were discharged alive with 94% recovering without need for further device therapy (Figure). Conclusions: This is the largest analysis of Impella-supported myocarditis cases to date. Theuse of the Impella appears to be safe and effectivein the settings of myocarditis complicated bycardiogenic shock.