OBJECTIVES: Survival after different short-term mechanical circulatory support is difficult to compare because various systems are used and patient disease severity is most often not adjusted for. This study compares the outcome after the use of Impella and veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in refractory cardiogenic shock, adjusted for disease severity through the survival after the VA-ECMO (SAVE) score. METHODS: Patients with refractory shock treated with either VA-ECMO or Impella between January 2003 and August 2015 were included. Data were analysed to assess short and long-term survival and complications. The SAVE score was calculated for the two groups and outcome was compared adjusted for the SAVE score. RESULTS: There was no difference between VA-ECMO patients (n=46) and Impella patients (n=48) in mean age or renal failure. ECMO patients were more often intubated and had lower diastolic blood pressure at device implantation. ECMO patients had a lower SAVE score (-0.4 (6.5)) compared to Impella patients (4.1 (5.4)). There was no difference in intensive care unit survival between ECMO patients 65% (52-80) or Impella patients 63% (55-79), or long-term survival between groups. When stratified into worse (III-IV) or better SAVE class (I-II) there was no difference in survival between the groups. CONCLUSIONS: Short and long-term survival is not measurably different among patients treated with Impella or VA-ECMO due to refractory cardiogenic shock, after adjustment for disease severity through the SAVE score.
OBJECTIVES: Survival after different short-term mechanical circulatory support is difficult to compare because various systems are used and patient disease severity is most often not adjusted for. This study compares the outcome after the use of Impella and veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in refractory cardiogenic shock, adjusted for disease severity through the survival after the VA-ECMO (SAVE) score. METHODS: Patients with refractory shock treated with either VA-ECMO or Impella between January 2003 and August 2015 were included. Data were analysed to assess short and long-term survival and complications. The SAVE score was calculated for the two groups and outcome was compared adjusted for the SAVE score. RESULTS: There was no difference between VA-ECMO patients (n=46) and Impella patients (n=48) in mean age or renal failure. ECMO patients were more often intubated and had lower diastolic blood pressure at device implantation. ECMO patients had a lower SAVE score (-0.4 (6.5)) compared to Impella patients (4.1 (5.4)). There was no difference in intensive care unit survival between ECMO patients 65% (52-80) or Impella patients 63% (55-79), or long-term survival between groups. When stratified into worse (III-IV) or better SAVE class (I-II) there was no difference in survival between the groups. CONCLUSIONS: Short and long-term survival is not measurably different among patients treated with Impella or VA-ECMO due to refractory cardiogenic shock, after adjustment for disease severity through the SAVE score.
Authors: Bernhard Wernly; Clemens Seelmaier; David Leistner; Barbara E Stähli; Ingrid Pretsch; Michael Lichtenauer; Christian Jung; Uta C Hoppe; Ulf Landmesser; Holger Thiele; Alexander Lauten Journal: Clin Res Cardiol Date: 2019-03-21 Impact factor: 5.460
Authors: Bernhard Wernly; Mina Karami; Annemarie E Engström; Stephan Windecker; Lukas Hunziker; Thomas F Lüscher; Jose P Henriques; Markus W Ferrari; Stephan Binnebößel; Maryna Masyuk; David Niederseer; Peter Abel; Georg Fuernau; Marcus Franz; Malte Kelm; Mathias C Busch; Stephan B Felix; Holger Thiele; Alexander Lauten; Christian Jung Journal: ESC Heart Fail Date: 2021-02-09
Authors: Clemens Scherer; Enzo Lüsebrink; Danny Kupka; Thomas J Stocker; Konstantin Stark; Christopher Stremmel; Mathias Orban; Tobias Petzold; Antonia Germayer; Katharina Mauthe; Stefan Kääb; Julinda Mehilli; Daniel Braun; Hans Theiss; Stefan Brunner; Jörg Hausleiter; Steffen Massberg; Martin Orban Journal: J Clin Med Date: 2020-11-24 Impact factor: 4.241
Authors: Alexander Assmann; Andreas Beckmann; Christof Schmid; Karl Werdan; Guido Michels; Oliver Miera; Florian Schmidt; Stefan Klotz; Christoph Starck; Kevin Pilarczyk; Ardawan Rastan; Marion Burckhardt; Monika Nothacker; Ralf Muellenbach; York Zausig; Nils Haake; Heinrich Groesdonk; Markus Ferrari; Michael Buerke; Marcus Hennersdorf; Mark Rosenberg; Thomas Schaible; Harald Köditz; Stefan Kluge; Uwe Janssens; Matthias Lubnow; Andreas Flemmer; Susanne Herber-Jonat; Lucas Wessel; Dirk Buchwald; Sven Maier; Lars Krüger; Andreas Fründ; Rolf Jaksties; Stefan Fischer; Karsten Wiebe; Christiane S Hartog; Omer Dzemali; Daniel Zimpfer; Elfriede Ruttmann-Ulmer; Christian Schlensak; Malte Kelm; Stephan Ensminger; Udo Boeken Journal: ESC Heart Fail Date: 2021-11-22