{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T21:27:59Z","timestamp":1767994079454,"version":"3.49.0"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,12,16]],"date-time":"2020-12-16T00:00:00Z","timestamp":1608076800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To describe hemodynamic efficacy and clinical outcomes of Impella percutaneous left ventricular assist device (pLVAD) in patients with cardiogenic shock (CS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Percutaneous LVADs are increasingly used in CS management. However, device\u2010related outcomes and optimal utilization remain active areas of investigation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All CS patients receiving pLVAD as mechanical circulatory support (MCS) between 2011 and 2017 were identified. Clinical characteristics and outcomes were analyzed. A multivariable logistic regression model was created to predict MCS escalation despite pLVAD. Outcomes were compared between early and late implantation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 115 CS patients (mean age 63.6\u2009\u00b1\u200913.8\u2009years; 69.6% male) receiving pLVAD as MCS were identified, the majority with CS secondary to acute myocardial infarction (AMI; 67.0%). Patients experienced significant cardiac output improvement (median 3.39\u2009L\/min to 3.90\u2009L\/min, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.002) and pharmacological support reduction (median vasoactive\u2010inotropic score [VIS] 25.4 to 16.4, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.049). Placement of extracorporeal membrane oxygenation (ECMO) occurred in 48 (41.7%) of patients. Higher pre\u2010pLVAD VIS was associated with subsequent MCS escalation in the entire cohort and AMI subgroup (OR 1.27 [95% CI 1.02\u20131.58], <jats:italic>p<\/jats:italic>\u00a0=\u00a0.034 and OR 1.72 [95% CI 1.04\u20132.86], <jats:italic>p<\/jats:italic>\u00a0=\u00a0.035, respectively). Complications were predominantly access site related (bleeding [9.6%], vascular injury [5.2%], and limb ischemia [2.6%]). In\u2010hospital mortality was 57.4%, numerically greater survival was noted with earlier device implantation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Treatment with pLVAD for CS improved hemodynamic status but did not uniformly obviate MCS escalation. Mortality in CS remains high, though earlier device placement for appropriately selected patients may be beneficial.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.29434","type":"journal-article","created":{"date-parts":[[2020,12,16]],"date-time":"2020-12-16T12:18:19Z","timestamp":1608121099000},"page":"37-47","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Impella percutaneous left ventricular assist device as mechanical circulatory support for cardiogenic shock: A retrospective analysis from a tertiary academic medical center"],"prefix":"10.1002","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5495-1109","authenticated-orcid":false,"given":"Shayan Nabavi","family":"Nouri","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine Columbia University Irving Medical Center, New York\u2010Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waqas","family":"Malick","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amirali","family":"Masoumi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Columbia University Irving Medical Center, New York\u2010Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin A.","family":"Fried","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Columbia University Irving Medical Center, New York\u2010Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veli K.","family":"Topkara","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Columbia University Irving Medical Center, New York\u2010Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2606-055X","authenticated-orcid":false,"given":"Michael I.","family":"Brener","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Columbia University Irving Medical Center, New York\u2010Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yousif","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Columbia University Irving Medical Center, New York\u2010Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megha","family":"Prasad","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Columbia University Irving Medical Center, New York\u2010Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"LeRoy E.","family":"Rabbani","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Columbia University Irving Medical Center, New York\u2010Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koji","family":"Takeda","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Department of Surgery Columbia University Irving Medical Center, New York\u2010Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios","family":"Karmpaliotis","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Columbia University Irving Medical Center, New York\u2010Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey W.","family":"Moses","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Columbia University Irving Medical Center, New York\u2010Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin B.","family":"Leon","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Columbia University Irving Medical Center, New York\u2010Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajay J.","family":"Kirtane","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Columbia University Irving Medical Center, New York\u2010Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7510-075X","authenticated-orcid":false,"given":"A. 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