Skip Navigation


European Heart Journal Advance Access originally published online on February 25, 2005
European Heart Journal 2005 26(13):1276-1283; doi:10.1093/eurheartj/ehi161
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
26/13/1276    most recent
ehi161v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (34)
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Thiele, H.
Right arrow Articles by Schuler, G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Thiele, H.
Right arrow Articles by Schuler, G.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oupjournals.org

Randomized comparison of intra-aortic balloon support with a percutaneous left ventricular assist device in patients with revascularized acute myocardial infarction complicated by cardiogenic shock

Holger Thiele*, Peter Sick, Enno Boudriot, Klaus-Werner Diederich, Rainer Hambrecht, Josef Niebauer and Gerhard Schuler

Department of Internal Medicine/Cardiology, University of Leipzig-Heart Centre, Strümpellstr. 39, 04289 Leipzig, Germany

Received 22 July 2004; revised 25 November 2004; accepted 6 January 2005; online publish-ahead-of-print 25 February 2005.

* Corresponding author. Tel: +49 341 865 1428; fax: +49 341 865 1461. E-mail address: thielh{at}medizin.uni-leipzig.de

Aims Mortality in cardiogenic shock (CS) following acute myocardial infarction (AMI) remains unacceptably high despite percutaneous coronary intervention (PCI) of the infarcted artery and use of intra-aortic balloon pump (IABP) counterpulsation. A newly developed percutaneous left ventricular assist device (VAD) (Tandem HeartTM, Cardiac Assist, Pittsburgh, PA, USA) with active circulatory support might have positive haemodynamic effects and decrease mortality.

Methods and results Patients in CS after AMI, with intended PCI of the infarcted artery, were randomized to either IABP (n=20) or percutaneous VAD support (n=21). The primary outcome measure cardiac power index, as well as other haemodynamic and metabolic variables, could be improved more effectively by VAD support from 0.22 [interquartile range (IQR) 0.19–0.30] to 0.37 W/m2 (IQR 0.30–0.47, P<0.001) when compared with IABP from 0.22 (IQR 0.18–0.30) to 0.28 W/m2 (IQR 0.24–0.36, P=0.02; P=0.004 for intergroup comparison). However, complications like severe bleeding (n=19 vs. n=8, P=0.002) or limb ischaemia (n=7 vs. n=0, P=0.009) were encountered more frequently after VAD support, whereas 30 day mortality was similar (IABP 45% vs. VAD 43%, log-rank, P=0.86).

Conclusion Haemodynamic and metabolic parameters can be reversed more effectively by VAD than by standard treatment with IABP. However, more complications were encountered by the highly invasive procedure and by the extracorporeal support.

Key Words: Shock • Heart-assist device • Extracorporeal circulation • Myocardial infarction


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
I. D. Gregoric, G. Poglajen, M. Span, O.H. Frazier, P. Loyalka, and B. Kar
Percutaneous ventricular assist device support during off-pump surgical coronary revascularization.
Ann. Thorac. Surg., August 1, 2008; 86(2): 637 - 639.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
H. R. Reynolds and J. S. Hochman
Cardiogenic Shock: Current Concepts and Improving Outcomes
Circulation, February 5, 2008; 117(5): 686 - 697.
[Full Text] [PDF]

Home page
 Card Surg AdultHome page
J. M. Wilson and J. T. Willerson
Myocardial Revascularization with Percutaneous Devices
Card. Surg. Adult, January 1, 2008; 3(2008): 573 - 598.
[Full Text]

Home page
 Eur J EchocardiogrHome page
M. Kooshkabadi, A. Kalogeropoulos, V. C. Babaliaros, and S. Lerakis
Transesophageal guided left atrial positioning of a percutaneous ventricular assist device
Eur J Echocardiogr, January 1, 2008; 9(1): 175 - 177.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. A. Pitsis, A. N. Visouli, D. Burkhoff, P. Dardas, N. Mezilis, G. Bougioukas, and G. Filippatos
Feasibility Study of a Temporary Percutaneous Left Ventricular Assist Device in Cardiac Surgery
Ann. Thorac. Surg., December 1, 2007; 84(6): 1993 - 1999.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
R. V. Jeger, A. M. Lowe, C. E. Buller, M. E. Pfisterer, V. Dzavik, J. G. Webb, J. S. Hochman, U. P. Jorde, and for the SHOCK Investigators
Hemodynamic Parameters Are Prognostically Important in Cardiogenic Shock But Similar Following Early Revascularization or Initial Medical Stabilization: A Report From the SHOCK Trial
Chest, December 1, 2007; 132(6): 1794 - 1803.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
H. Thiele, R. W. Smalling, and G. C. Schuler
Percutaneous left ventricular assist devices in acute myocardial infarction complicated by cardiogenic shock
Eur. Heart J., September 1, 2007; 28(17): 2057 - 2063.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
B. G. Leshnower, T. G. Gleason, M. L. O'Hara, A. Pochettino, Y. J. Woo, R. J. Morris, T. J. Gardner, and M. A. Acker
Safety and Efficacy of Left Ventricular Assist Device Support in Postmyocardial Infarction Cardiogenic Shock
Ann. Thorac. Surg., April 1, 2006; 81(4): 1365 - 1371.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
D. Mancini and D. Burkhoff
Mechanical Device-Based Methods of Managing and Treating Heart Failure
Circulation, July 19, 2005; 112(3): 438 - 448.
[Abstract] [Full Text] [PDF]


Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.