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Use of Impella cardiac axial flow pump for cardiogenic shock (A newer alternative)–How good is the evidence?

RAFIQ AHMED BHAT1, SYED MANZOOR ALI2, YOOSUF ALI ASHRAF MUHAMMAD HUSSENBOCUS3, AKANKSHA RATHI4, JAVAID AKHTER BHAT5, ABDUL ALEEM KHAN6, SYED MAQBOOL2, RAJA SAQIB IQBAL7, MD MONOWARUL ISLAM8, YONGSHENG QU9, YOU ZHANG9, YUXIAO SUN1, WENTAO XIAO9, ABHISHEK TIBREWAL10, CHUANYU GAO1,*

1 Zhengzhou University People’s Hospital, Department of Cardiology, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
2 Department of Cardiology, Super Speciality Division, Government Medical College, Srinagar, India
3 Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
4 Department of Community Medicine, Vedanta Institute of Medical Sciences, Palghar, India
5 State Key Laboratory of Crop Genetics and Germplasm Enhancement, Nanjing Agricultural University, Nanjing, China
6 Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
7 Department of Paediatrics, Batra Hospital and Medical Research Centre, New Delhi, India
8 Zhengzhou University First Affiliated Hospital, Zhengzhou, China
9 Zhengzhou University People’s Hospital, Department of Cardiology, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
10 Department of Community Medicine, Institute of Biostatistics and Epidemiology, Gurgaon, India

* Address correspondence to: Chuanyu Gao, email

(This article belongs to this Special Issue: Cellular Biomechanics in Health and Diseases)

BIOCELL 2022, 46(5), 1139-1150. https://doi.org/10.32604/biocell.2022.016833

Abstract

The adverse outcomes of a ventricular heart failure (left, right or biventricular) caused by cardiogenic shock are aggravated by lung oedema and organ mal perfusion. Despite advances in medical sciences, revascularisation and mechanical hemodynamic support have proved ineffective in reducing the mortality rate in such patients. A thorough study of the data available about cardio-vascular diseases reveals that the application of conventional methods of treatment are least helpful to practically restore normal functions of heart when it experiences end-stage systolic ventricular failure. Thus, to overcome the challenges and find alternatives to address this issue, percutaneous ventricular support devices/machines were designed and successfully introduced. These devices have revolutionized the treatment of ventricular heart failures and are now in use all over the world. In this review paper a newer mechanical circulatory support (MCS) device, Impella, has been discussed and compared with a few other devices like (Intra-aortic Balloon Pump (IABP), Extracorporeal Circulation (ECLS) and Veno-arterial Extracorporeal Membrane Oxygenation (VA-ECMO). This article studies the challenges being faced during the treatment of cardiogenic shock, and thoroughly discusses the use and effectiveness of Impella Cardiac Axial Pump in each emergency. It can be said that mechanical circulatory support (MCS) device use during percutaneous coronary intervention (PCI) should be individualized based on multiple factors with a recommended use in patients with the greatest potential benefit and a relatively low risk of device-related complications. The current literature suggests that the outcomes of use of Impella and other mechanical circulatory support devices like IABP and VA-ECMO are comparable. Though there seem to be a few advantages of Impella over the others, sufficiently powered, multi-centric, randomised control trials are needed to establish its superiority.

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Cite This Article

BHAT, R. A., ALI, S. M., ALI, Y., RATHI, A., BHAT, J. A. et al. (2022). Use of Impella cardiac axial flow pump for cardiogenic shock (A newer alternative)–How good is the evidence?. BIOCELL, 46(5), 1139–1150.



cc This work is licensed under a Creative Commons Attribution 4.0 International License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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