Ischemia/Reperfusion during Cardiac Arrest

Post-resuscitation death contributes significantly to overall OHCA mortality Most patients who achieve ROSC, die after 24-72 hours of the post-resuscitation syndrome Post-resuscitation syndrome is characterized by cardiovascular dysfunction multi-organ failure failure of CNS recovery has similarity with sepsis syndrome compared…

Impella left ventricular assist device

Overview Impella is a catheter-based percutaneous ventricular assist device (VAD) with a continuous axial flow pump with a propeller at the tip of the catheter, positioned in a retrograde way across the aortic valve to directly vent the left ventricle…

TandemHeart

Overview TandemHeart is a percutaneous ventricular assist device (VAD) consisting of an extracorporeal centrifugal continuous flow pump that drains blood from the left atrium via a cannula introduced through the femoral vein and extended transseptally from the right atrium to…

Cardiogenic Shock

Cardiac disorder that results in both clinical and biochemical evidence of tissue hypoperfusion. Definition from clinical trials SHOCK Trial Clinical criteria: SPB < 90 mmHg for ≥ 30 minutes OR support to maintain SPB ≥ 90 mmHg AND end-organ hypoperfusion…

Temporary Mechanical Circulatory Devices

Percutaneous Mechanical Circulatory Devices (MCS) Micro-axial Impella 2.5, CP, and 5.0 systems TandemHeart Investigational devices Paracorporeal pulsatile iVAC 2L HeartMate Percutaneous Heart Pump Extracorporeal Membrane Oxygenation (ECMO) Right Ventricular support Other mechanical terapies

Level of Evidence

Level of Evidence A Data derived from multiple randomized clinical trials or meta-analyses of such studies. Level of Evidence B Level of Evidence B-R: Data derived from one or more randomized trials or meta-analysis of such studies. Level of Evidence B-NR: Data…

Classification of Recommendations

Class I: Benefit >>> Risk Conditions for which there is evidence and/or general agreement that a given procedure or treatment is beneficial, useful, and effective. Class II: Conditions for which there is conflicting evidence and/or a divergence of opinion about…

Intra-Aortic Balloon Pump

Intra-Aortic Balloon Pump (IABP) counterpulsation is the most widely used mechanical circulatory devices in cardiogenic shock. Physiology of IABP counterpulsation The device inflates and deflates in concert with the cardiac cycle, increasing the diastolic blood pressure and reducing the systolic…