Author + information
- Sudeep Kuchibhotla,
- Michele Esposito,
- Michael Kiernan,
- Mark Grise,
- Dennis Morris,
- Duc Thinh Pham and
- Navin Kapur
Background: Biventricular Impella (BiPella) is a novel acute mechanical support strategy for patients with BiVF. We hypothesized that indices of right ventricular-pulmonary arterial coupling are associated with clinical outcomes among BiPella recipients.
Methods: We retrospectively analyzed hemodynamic data from 20 patients receiving BiPella for BiVF from 3 tertiary-care hospitals.
Results: BiVF was due to acute MI (n=10), advanced heart failure (n=8), and myocarditis (n=2). Mean LV ejection fraction was 23±13%. All BiPella patients had an elevated RAP (21±5), elevated PCWP (24±5), decreased pulmonary artery pulsatility index (PAPi, 1.0±0.7) and decreased CI (1.8±0.4) before device activation. Bipella activation improved RAP (21±5 vs 13±4), PCWP (24±5 vs 19±4), and CI (1.8±0.4 vs 2.2±0.7; p<0.05 for all comparisons). Compared to survivors, in non-survivors, no difference in RAP, RAP:PCWP, PAPi, or CI was observed. Non-survivors had higher RV-Ea and RV-Ea corrected for left atrial pressure (Eff-RV-Ea), higher TPG, and lower PAC before device implant (Table 1).
Conclusions: This is the first analysis of hemodynamic profiles in patients receiving BiPella therapy for cardiogenic shock. Our findings identify RV load as a major determinant of clinical outcomes in this population.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Novel Developments in Acute Coronary Syndromes
Abstract Category: 15. Interventional Cardiology: ACS/AMI/Hemodynamics and Pharmacology
Presentation Number: 1194-148
- 2017 American College of Cardiology Foundation