Skip to main content

Prognostic implication of risk scoring systems in patients with cardiogenic shock supported by ECMO and Impella

Journal of Artificial Organs volume 24, pages 372–376 (2021)Cite this article

Abstract

We experienced two refractory cardiogenic shock patients receiving veno-arterial extracorporeal membrane oxygenation and Impella percutaneous left ventricular assist device (ECPELLA). TVAD score, which was originally proposed to predict one-year mortality following left ventricular assist device implantation using four objective parameters, was retrospectively calculated using data of day 3 following ECPELLA initiations. One patient with estimated intermediate risk could achieve successful explantation of ECPELLA, whereas another patient with estimated high risk was expired despite explantation of extracorporeal membrane oxygenation. TVAD score might be a useful tool to risk stratify and construct next strategy (i.e., bridge to recovery or bridge to more intensive therapy) for those with ECPELLA, although further studies are warranted to validate this hypothesis.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2

References

  1. Negi SI, Sokolovic M, Koifman E, et al. Contemporary use of veno-arterial extracorporeal membrane oxygenation for refractory cardiogenic shock in acute coronary syndrome. J Invasive Cardiol. 2016;28:52–7.

    PubMed  Google Scholar 

  2. Smith M, Vukomanovic A, Brodie D, et al. Duration of veno-arterial extracorporeal life support (VA ECMO) and outcome: an analysis of the Extracorporeal Life Support Organization (ELSO) registry. Crit Care. 2017;21:45.

    Article  Google Scholar 

  3. Burkhoff D, Sayer G, Doshi D, Uriel N. Hemodynamics of mechanical circulatory support. J Am Coll Cardiol. 2015;66:2663–74.

    Article  Google Scholar 

  4. Nakamura M, Imamura T, Ueno H, Kinugawa K. Current indication and practical management of percutaneous left ventricular assist device support therapy in Japan. J Cardiol. 2020;75:228–32.

    Article  Google Scholar 

  5. Patel SM, Lipinski J, Al-Kindi SG, et al. Simultaneous venoarterial extracorporeal membrane oxygenation and percutaneous left ventricular decompression therapy with Impella is associated with improved outcomes in refractory cardiogenic shock. ASAIO J. 2019;65:21–8.

    Article  Google Scholar 

  6. Imamura T, Kinugawa K, Shiga T, et al. Novel risk scoring system with preoperative objective parameters gives a good prediction of 1-year mortality in patients with a left ventricular assist device. Circ J. 2012;76:1895–903.

    Article  Google Scholar 

  7. Imamura T, Kinugawa K, Shiga T, et al. Preoperative levels of bilirubin or creatinine adjusted by age can predict their reversibility after implantation of left ventricular assist device. Circ J. 2013;77:96–104.

    CAS  Article  Google Scholar 

  8. Lee SI, Hwang HJ, Lee SY, et al. Veno-veno-arterial extracorporeal membrane oxygenation for acute respiratory distress syndrome with septic-induced cardiomyopathy due to severe pulmonary tuberculosis. J Artif Organs. 2017;20:359–64.

    Article  Google Scholar 

  9. Nakamura M, Imamura T, Fukui T, et al. Impact of the angle between aortic and mitral annulus on the occurrence of hemolysis during Impella support. J Artif Organs. 2020;23:207–13.

    Article  Google Scholar 

  10. Esposito ML, Morine KJ, Annamalai SK, et al. Increased plasma-free hemoglobin levels identify hemolysis in patients with cardiogenic shock and a trans valvular micro-axial flow pump. Artif Organs. 2019;43:125–31.

    CAS  Article  Google Scholar 

  11. Fahad F, Saad Shaukat MH, Yager N. Incidence and outcomes of acute kidney injury requiring renal replacement therapy in patients on percutaneous mechanical circulatory support with Impella-CP for cardiogenic shock. Cureus. 2020;12:e6591.

    PubMed  PubMed Central  Google Scholar 

  12. Kochav SM, Flores RJ, Truby LK, Topkara VK. Prognostic impact of pulmonary artery pulsatility index (PAPi) in patients with advanced heart failure: insights from the ESCAPE trial. J Card Fail. 2018;24:453–9.

    Article  Google Scholar 

Download references

Funding

None.

Author information

Affiliations

  1. The Second Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan

    Makiko Nakamura, Teruhiko Imamura, Masakazu Hori & Koichiro Kinugawa

  2. Department of Cardiovascular Surgery, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan

    Shigeki Yokoyama, Toshio Doi & Kazuaki Fukahara

Authors
  1. Makiko Nakamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Teruhiko Imamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masakazu Hori
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shigeki Yokoyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Toshio Doi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kazuaki Fukahara
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Koichiro Kinugawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Teruhiko Imamura.

Ethics declarations

Conflict of interest

There is no conflict of interest related to this manuscript.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Nakamura, M., Imamura, T., Hori, M. et al. Prognostic implication of risk scoring systems in patients with cardiogenic shock supported by ECMO and Impella. J Artif Organs 24, 372–376 (2021). https://doi.org/10.1007/s10047-020-01232-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10047-020-01232-6

Keywords

  • Left ventricular assist device
  • Mechanical circulatory support
  • ECPELLA