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Impella support following emergency percutaneous balloon aortic valvuloplasty in patients with severe aortic valve stenosis and cardiogenic shock.

Impella support following emergency percutaneous balloon aortic valvuloplasty in patients with severe aortic valve stenosis and cardiogenic shock.
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Karatolios K, Chatzis G, Luesebrink U, Markus B, Ahrens H, Tousoulis D, Schieffer B,


Karatolios K, Chatzis G, Luesebrink U, Markus B, Ahrens H, Tousoulis D, Schieffer B, (click to view)

Karatolios K, Chatzis G, Luesebrink U, Markus B, Ahrens H, Tousoulis D, Schieffer B,

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Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese 2018 03 20() pii S1109-9666(17)30541-9
Abstract
BACKGROUND
To investigate the feasibility and outcomes of Impella 2.5 support in patients with severe aortic valve stenosis (AS) and cardiogenic shock (CS) who underwent emergency percutaneous balloon aortic valvuloplasty (BAV) with or without percutaneous coronary intervention (PCI).

METHODS AND RESULTS
We retrospectively analyzed a consecutive series of patients with severe AS and CS who underwent Impella 2.5 support following emergency BAV with or without subsequent PCI. Outcome data included 30-day outcomes, periprocedural as well as throughout the circulatory support period complications. Eight patients with severe AS and CS were identified. Impella 2.5 implantation was successful following emergency BAV in all patients attempted. Additional PCI was performed in 4 patients. No periprocedural deaths or periprocedural neurologic events occurred. Mean procedure time was 125.9 min (range 64-210min). Mortality at 30-days was 50%.

CONCLUSIONS
Impella 2.5 can be used as hemodynamic support in patients with severe AS and CS following emergency percutaneous BAV and may help to improve tolerability of PCI in these high-risk patients.

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