THURSDAY, Oct. 14 (HealthDay News) -- Implantation of a percutaneous ventricular assist device (pVAD) can rapidly improve hemodynamic parameters in patients with severe refractory cardiogenic shock (SRCS) despite intra-aortic balloon pump (IABP) and vasopressor support, according to research published online Oct. 13 in the Journal of the American College of Cardiology.
Biswajit Kar, M.D., of the Texas Heart Institute at St. Luke's Episcopal Hospital and Baylor College of Medicine in Houston, and colleagues conducted a study to evaluate the efficacy and safety of a pVAD in patients in SRCS despite IABP and/or high-dose vasopressor support. The TandemHeart pVAD (CardiacAssist Inc., Pittsburgh) was implanted in 117 patients, 80 of whom had ischemic cardiomyopathy.
Cardiovascular parameters improved after the implantation, with a significantly increased median cardiac index, higher systolic blood pressure (increased from 75 to 100 mm Hg), better mixed venous oxygen saturation, and increased urinary output. The pulmonary capillary wedge pressure decreased from 31.53 to 17.29 mm Hg. Mortality rates were 40.2 percent at 30 days and 45.3 percent at six months.
"The TandemHeart is an effective treatment option for rapidly reversing terminal circulatory collapse and is associated with less device-associated morbidity and mortality. Further prospective randomized trials are warranted to evaluate the efficacy of early pVAD placement in SRCS patients, though these are very difficult to conduct in patients with cardiogenic shock," the authors write.
The Texas Heart Institute has been a training center for CardiacAssist since 2009. All the patients in this study were included before this relationship was established.
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