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• W4323038544 abstract "Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is used to provide temporary mechanical circulatory support in patients with refractory cardiogenic shock (CS) or cardiac arrest. Due to the increased afterload from retrograde aortic flow, VA-ECMO is associated with increased left ventricular (LV) filling pressures, higher myocardial oxygen demand, and impaired LV recovery. 1 Russo JJ Aleksova N Pitcher I Couture E Parlow S Faraz M Visintini S Simard T Di Santo P Mathew R So DY Takeda K Garan AR Karmpaliotis D Takayama H Kirtane AJ Hibbert B. Left ventricular unloading during extracorporeal membrane oxygenation in patients with cardiogenic shock. J Am Coll Cardiol. 2019; 73: 654-662 Crossref PubMed Scopus (198) Google Scholar Several LV unloading strategies, including the use of intra-aortic balloon pump, percutaneous LV assist devices (e.g., Impella [Abiomed, Danvers, Massachusetts]), or atrial septostomy, have been described in previous studies. 1 Russo JJ Aleksova N Pitcher I Couture E Parlow S Faraz M Visintini S Simard T Di Santo P Mathew R So DY Takeda K Garan AR Karmpaliotis D Takayama H Kirtane AJ Hibbert B. Left ventricular unloading during extracorporeal membrane oxygenation in patients with cardiogenic shock. J Am Coll Cardiol. 2019; 73: 654-662 Crossref PubMed Scopus (198) Google Scholar , 2 Al-Fares AA Randhawa VK Englesakis M McDonald MA Nagpal AD Estep JD Soltesz EG Fan E Optimal strategy and timing of left ventricular venting during veno-arterial extracorporeal life support for adults in cardiogenic shock: A systematic review and meta-analysis. Circ Heart Fail. 2019; 12e006486 Crossref PubMed Scopus (56) Google Scholar , 3 Schrage B Becher PM Bernhardt A Bezerra H Blankenberg S Brunner S Colson P Cudemus Deseda G Dabboura S Eckner D Eden M Eitel I Frank D Frey N Funamoto M Goßling A Graf T Hagl C Kirchhof P Kupka D Landmesser U Lipinski J Lopes M Majunke N Maniuc O McGrath D Möbius-Winkler S Morrow DA Mourad M Noel C Nordbeck P Orban M Pappalardo F Patel SM Pauschinger M Pazzanese V Reichenspurner H Sandri M Schulze PC Schwinger HG R Sinning JM Aksoy A Skurk C Szczanowicz L Thiele H Tietz F Varshney A Wechsler L Westermann D Left ventricular unloading is associated with lower mortality in patients with cardiogenic shock treated with venoarterial extracorporeal membrane oxygenation: Results from an international, multicenter cohort study. Circulation. 2020; 142: 2095-2106 Crossref PubMed Scopus (140) Google Scholar , 4 Mourad M Gaudard P De La Arena P Eliet J Zeroual N Rouvière P Roubille F Albat B Colson PH. Circulatory support with extracorporeal membrane oxygenation and/or impella for cardiogenic shock during myocardial infarction. ASAIO J. 2018; 64 (2018): 708-714 Crossref PubMed Scopus (32) Google Scholar , 5 Akanni OJ Takeda K Truby LK Kurlansky PA Chiuzan C Han J Topkara VK Yuzefpolskaya M Colombo PC Karmpaliotis D Moses JW Naka Y Garan AR Kirtane AJ Takayama H. EC-VAD: combined use of extracorporeal membrane oxygenation and percutaneous microaxial pump left ventricular assist device. ASAIO J. 2019; 65: 219-226 Crossref PubMed Scopus (37) Google Scholar , 6 Pappalardo F Schulte C Pieri M Schrage B Contri R Soeffker G Greco T Lembo R Müllerleile K Colombo A Sydow K De Bonis M Wagner F Reichenspurner H Blankenberg S Zangrillo A Westermann D. Concomitant implantation of Impella® on top of veno-arterial extracorporeal membrane oxygenation may improve survival of patients with cardiogenic shock. Eur J Heart Fail. 2017; 19: 404-412 Crossref PubMed Scopus (313) Google Scholar A previous meta-analysis by Russo et al 1 Russo JJ Aleksova N Pitcher I Couture E Parlow S Faraz M Visintini S Simard T Di Santo P Mathew R So DY Takeda K Garan AR Karmpaliotis D Takayama H Kirtane AJ Hibbert B. Left ventricular unloading during extracorporeal membrane oxygenation in patients with cardiogenic shock. J Am Coll Cardiol. 2019; 73: 654-662 Crossref PubMed Scopus (198) Google Scholar showed that LV unloading was associated with a decrease in mortality in patients with CS. Similarly, a meta-analysis by Al-Fares et al 2 Al-Fares AA Randhawa VK Englesakis M McDonald MA Nagpal AD Estep JD Soltesz EG Fan E Optimal strategy and timing of left ventricular venting during veno-arterial extracorporeal life support for adults in cardiogenic shock: A systematic review and meta-analysis. Circ Heart Fail. 2019; 12e006486 Crossref PubMed Scopus (56) Google Scholar demonstrated that LV venting was associated with reduction in short-term mortality and the survival benefit was observed when LV was vented early (i.e., <12 hours). However, the subgroup analysis of these meta-analyses 1 Russo JJ Aleksova N Pitcher I Couture E Parlow S Faraz M Visintini S Simard T Di Santo P Mathew R So DY Takeda K Garan AR Karmpaliotis D Takayama H Kirtane AJ Hibbert B. Left ventricular unloading during extracorporeal membrane oxygenation in patients with cardiogenic shock. J Am Coll Cardiol. 2019; 73: 654-662 Crossref PubMed Scopus (198) Google Scholar ,2 Al-Fares AA Randhawa VK Englesakis M McDonald MA Nagpal AD Estep JD Soltesz EG Fan E Optimal strategy and timing of left ventricular venting during veno-arterial extracorporeal life support for adults in cardiogenic shock: A systematic review and meta-analysis. Circ Heart Fail. 2019; 12e006486 Crossref PubMed Scopus (56) Google Scholar have shown no survival benefit with Impella as an LV unloading strategy in VA-ECMO (ECPELLA strategy). A large multicenter cohort study was published by Schrage et al 3 Schrage B Becher PM Bernhardt A Bezerra H Blankenberg S Brunner S Colson P Cudemus Deseda G Dabboura S Eckner D Eden M Eitel I Frank D Frey N Funamoto M Goßling A Graf T Hagl C Kirchhof P Kupka D Landmesser U Lipinski J Lopes M Majunke N Maniuc O McGrath D Möbius-Winkler S Morrow DA Mourad M Noel C Nordbeck P Orban M Pappalardo F Patel SM Pauschinger M Pazzanese V Reichenspurner H Sandri M Schulze PC Schwinger HG R Sinning JM Aksoy A Skurk C Szczanowicz L Thiele H Tietz F Varshney A Wechsler L Westermann D Left ventricular unloading is associated with lower mortality in patients with cardiogenic shock treated with venoarterial extracorporeal membrane oxygenation: Results from an international, multicenter cohort study. Circulation. 2020; 142: 2095-2106 Crossref PubMed Scopus (140) Google Scholar , which showed that Impella-mediated LV unloading was associated with lower mortality in patients with CS being treated with VA-ECMO. We sought to conduct an updated meta-analysis of previous studies for outcomes with ECPELLA (VA-ECMO with Impella unloading) use compared with VA-ECMO alone in CS." @default.
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• W4323038544 date "2023-04-01" @default.
• W4323038544 modified "2023-10-14" @default.
• W4323038544 title "Meta-Analysis on Left Ventricular Unloading With Impella in Patients With Cardiogenic Shock Receiving Venoarterial Extracorporeal Membrane Oxygenation" @default.
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• W4323038544 doi "https://doi.org/10.1016/j.amjcard.2023.01.053" @default.
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