scholarly journals Impella Induced Massive Hemolysis: Reemphasizing Echocardiographic Guidance for Correct Placement

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Shaun Cardozo ◽  
Tasneem Ahmed ◽  
Kevin Belgrave
Keyword(s):  
High Risk ◽  
Cardiogenic Shock ◽  
Hemolytic Anemia ◽  
Ultrasound Guidance ◽  
Imaging Modalities ◽  
Correct Placement ◽  
Coronary Procedures ◽  
Unnecessary Complication

The Impella LP 2.5 (Abiomed, Danvers, MA) has been a tool of use for high risk coronary procedures and for cardiogenic shock. As with any invasive or intracardiac device, improper placement can result in disastrous complications. Hemolytic anemia secondary to Impella implantation is one of the documented complications. However, cases of severe hemolytic anemia are rare in the literature. Proven imaging modalities like ultrasound need to be used to guide proper placement. We present a case of device induced severe hemolysis due to Impella insertion and the need to use ultrasound guidance to avoid such an unnecessary complication.

Percutaneous left ventricular support for high-risk PCI and cardiogenic shock: who gets what?

2012 ◽  
Vol 13 (2) ◽  
pp. 101-105 ◽  
Author(s):  
Roshni Shah ◽  
Alexcis Thomson ◽  
Kimberly Atianzar ◽  
Keith Somma ◽  
Anilkumar Mehra ◽  
...  
Keyword(s):  
High Risk ◽  
Cardiogenic Shock ◽  
Left Ventricular ◽  
Ventricular Support

scholarly journals 1065 Screening for Occult Midgut Carcinoid Tumor in High Risk Individuals Using Functional and Anatomic Imaging Modalities: Results of a Prospective Study

2012 ◽  
Vol 142 (5) ◽  
pp. S-189
Author(s):  
Apurva Trivedi ◽  
Joanne Forbes ◽  
Grishma Joy ◽  
Martha Quezado ◽  
Adeline Louie ◽  
...  
Keyword(s):  
High Risk ◽  
Prospective Study ◽  
Carcinoid Tumor ◽  
Imaging Modalities ◽  
Midgut Carcinoid ◽  
A Prospective Study

scholarly journals Using Machine Learning for Early Prediction of Cardiogenic Shock in Patients with Acute Heart Failure

2021 ◽  
Author(s):  
Faisal Rahman ◽  
Noam Finkelstein ◽  
Anton Alyakin ◽  
Nisha Gilotra ◽  
Jeff Trost ◽  
...  
Keyword(s):  
Heart Failure ◽  
High Risk ◽  
Cardiogenic Shock ◽  
Risk Model ◽  
Acute Decompensated Heart Failure ◽  
Clinical Care ◽  
Delayed Diagnosis ◽  
Low Risk ◽  
Cohort Identification ◽  
High Risk Cohort

Abstract Objective: Despite technological and treatment advancements over the past two decades, cardiogenic shock (CS) mortality has remained between 40-60%. A number of factors can lead to delayed diagnosis of CS, including gradual onset and nonspecific symptoms. Our objective was to develop an algorithm that can continuously monitor heart failure patients, and partition them into cohorts of high- and low-risk for CS.Methods: We retrospectively studied 24,461 patients hospitalized with acute decompensated heart failure, 265 of whom developed CS, in the Johns Hopkins Healthcare system. Our cohort identification approach is based on logistic regression, and makes use of vital signs, lab values, and medication administrations recorded during the normal course of care. Results: Our algorithm identified patients at high-risk of CS. Patients in the high-risk cohort had 10.2 times (95% confidence interval 6.1-17.2) higher prevalence of CS than those in the low-risk cohort. Patients who experienced cardiogenic shock while in the high-risk cohort were first deemed high-risk a median of 1.7 days (interquartile range 0.8 to 4.6) before cardiogenic shock diagnosis was made by their clinical team. Conclusions: This risk model was able to predict patients at higher risk of CS in a time frame that allowed a change in clinical care. Future studies need to evaluate if CS analysis of high-risk cohort identification may affect outcomes.

scholarly journals The Role of Percutaneous Haemodynamic Support in High-risk Percutaneous Coronary Intervention and Cardiogenic Shock

2015 ◽  
Vol 10 (1) ◽  
pp. 39 ◽  
Author(s):  
Dagmar M Ouweneel ◽  
Bimmer E Claessen ◽  
Krischan D Sjauw ◽  
José PS Henriques ◽  
◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
High Risk ◽  
Cardiogenic Shock ◽  
Coronary Intervention ◽  
Assist Devices ◽  
Cardiac Assist ◽  
Cardiac Assist Devices ◽  
Percutaneous Coronary ◽  
Haemodynamic Improvement

The experience and usage of percutaneous cardiac assist devices in cardiogenic shock as well as high-risk percutaneous coronary intervention have increased over the years. Nonetheless, there is still little evidence of clinical benefit of these devices other than immediate haemodynamic improvement. Despite the fact that these devices are used to treat a rather complex patient population, clinical testing remains important in order to evaluate their true impact on clinical outcome before being adopted into clinical practice. Therefore, this review shows an overview of the current experience and evidence of the available percutaneous cardiac assist devices.

Presurgical, ultrasound-guided anchor-wire marking of impalpable cervical lymph nodes

2005 ◽  
Vol 119 (8) ◽  
pp. 627-628 ◽  
Author(s):  
J A Bryant ◽  
N J Siddiqi ◽  
E J Loveday ◽  
G H Irvine
Keyword(s):  
Lymph Node ◽  
High Risk ◽  
Lymph Nodes ◽  
Cervical Lymph Node ◽  
Ultrasound Guidance ◽  
Operating Time ◽  
High Risk Patient ◽  
Wire Localization ◽  
Ultrasound Guided ◽  
Cervical Lymph Nodes

This case illustrates the surgical use of wire localization, a well tried technique from a different field of surgery, in the removal of an ultrasound-detected, impalpable deep lower cervical lymph node in a high-risk patient. A localization needle with an echogenic tip was placed freehand under ultrasound guidance, immediately before surgery. The imaging and marking of the impalpable cervical lymph node resulted in a precise surgical dissection and a reduction in operating time whilst minimizing risks to the patient and staff.

Percutaneous Mechanical Circulatory Support Devices Use in Cardiogenic Shock and High-Risk Percutaneous Intervention.

2021 ◽  
Vol 8 (08) ◽  
pp. 5578-5583
Author(s):  
Usman Sarwar ◽  
Nikky Bardia ◽  
Amod Amritphale ◽  
Hassan Tahir ◽  
MD Ghulam M.Awan
Keyword(s):  
Percutaneous Coronary Intervention ◽  
High Risk ◽  
Cardiogenic Shock ◽  
Mechanical Circulatory Support ◽  
Coronary Intervention ◽  
Percutaneous Intervention ◽  
Circulatory Support ◽  
Percutaneous Coronary ◽  
Mechanical Circulatory Support Devices ◽  
Support Devices

Statistical data has shown that patients now treated in cardiac catheterization laboratories are older with several comorbidities, including renal failure, diabetes, and heart failure [1]. In past patients who were not suitable candidates for percutaneous coronary intervention due to their numerous comorbidities now seems to be a suitable candidate due to tremendous advancements in the field of interventional cardiology like new stent design and availability of advance mechanical circulatory support devices, i.e., Impella performing PCI on these high-risk patients become a viable option. There are two areas of cardiology in which mechanical circulatory support devices keep evolving: one is high-risk (percutaneous coronary intervention) PCI, and the other is a cardiogenic shock that is refractory to initial pressor support.  In this article, we review evidence base data regarding the use of mechanical circulatory support devices in high-risk percutaneous intervention and cardiogenic shock.

Prophylactic LVAD Enabling High-Risk Mitral Repair—Extending Beyond the Guidelines

2019 ◽  
Vol 14 (6) ◽  
pp. 573-576
Author(s):  
Fadi Hage ◽  
Ali Hage ◽  
Stuart Smith ◽  
A. Dave Nagpal ◽  
Michael W. A. Chu
Keyword(s):  
High Risk ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Cardiogenic Shock ◽  
Clinical Symptoms ◽  
Left Ventricular ◽  
Lv Function ◽  
Assist Device ◽  
Mitral Repair ◽  
Lv Dysfunction

Both surgical and percutaneous mitral repair remain contraindicated in patients with severe degenerative mitral regurgitation (DMR) with severe left ventricular (LV) dysfunction because of inadequate LV reserve and increased LV work with a competent mitral valve. We report a 55-year-old gentleman who presented in cardiogenic shock with missed severe DMR and severe LV dysfunction, in whom we performed a high-risk mitral repair and insertion of a prophylactic CentriMag LV assist device. This innovative approach was found to be successful with significant patient improvement in both LV function and clinical symptoms with a competent mitral valve.

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