Discover and read the best of Twitter Threads about #impella

Most recents (8)

Our @MarinaPieri4 now presenting at @EACTAIC webinar: native heart recovery is the first choice option! ImageImageImageImage
2 RCTs are running on #levosimendan in VE #ECMO weaning @EACTAIC

Dieter Dauwe Image
In a patient with #ECPELLA #ECMELLA

Which device do you wean first?
#ECMO or #IMPELLA

Dieter Dauwe @DauweDieter
@EACTAIC @MarinaPieri4 Image
Read 7 tweets
Very happy to see our #UNLOADECMO trial started in 12/22 with 4 patients already included.
#MCS therapy in cardiogenic shock still very challenging.
#ECLS-SHOCK (#ECMO)and #DanGer-Shock (#Impella) running already and will be finished soon.

What are we investigating?🧵1/6 below:
🧵2/6 @BenediktSchrage showed earlier that "LV Unloading Is Associated With Lower Mortality in Patients With CS Treated With VA-ECMO"
ahajournals.org/doi/10.1161/CI…

Large study (686 patients), but obviously not prospective and randomized. But that's needed in CS (and everywhere)
🧵3/6 Others @benhibbertMDPhD showed this as well in a meta-analysis @jaccjournals jacc.org/doi/10.1016/j.…
Read 8 tweets
Please retweet and share if you support my and others' vaccine injury recoveries. Image
My fiancé and I were supposed to get married in July 2022. Given the first 2 vaccine mandates, we figured that we had no choice but to keep on taking the boosters in order to be able to travel for our honeymoon / have liberties to go to stores etc.
We decided to take the 3rd @moderna_tx booster anticipating that perhaps it would also be mandated by the #Canadian #government.
Read 76 tweets
Morning everyone. Here’s a challenge to start the day. Can you figure out what MCS this patient is receiving by looking at these pipes??
You can see the 4 cannulae in this X-ray. The RVAD drainage is from the RA and returns to the PA. The LVAD drains LV apex and returns to ascending aorta. You’ll also notice the lungs look ok and the patient isn’t intubated….. so why the oxygenator in the RVAD…….?
Read 8 tweets
3/ A little out of the realm of this thread, #Impella and other mechanical circulatory support are part of a larger strategy to treat cardiogenic shock. Check out the @SCAI classification system below for more information

ImageImage
4/ Impellas are placed via femoral or axillary artery, into the aorta, & across the aortic valve. There is an inlet on the LV side and an outlet on the aortic side. There are a number of different Impellas, each of which have different flow rates, lumen size, and access needs. 👇 Image
5/ However, the structural design Impellas is grossly similar. The tip of the catheter has a flexible pigtail, intended to prevent mechanical injury of the ventricle (absent on the larger LD and 5.5 models). Important- look at the flow rate, up to 5 LPM with the 5.5! 🤯 Image
Read 8 tweets
1/9 🅲🅰🆂🅴-🅱🅰🆂🅴🅳 🆃🆄🆃🅾🆁🅸🅰🅻 4
MECHANICAL CIRCULATORY SUPPORT

@ACCinTouch @agtruesdell @ErikOsborn77 @mirvatalasnag #ACCIC #PedsCICU #PedsCards

🔹Background
🔹#PedsICU #ECMO Case
🔹Adult ECMO + #Impella Case
🔹Upcoming Webinar
2/9 EARLY RUNS OF #COVID19 PATIENTS ON #ECMO

Initial discouraging reports from 🇨🇳
Warning of igniting immune storm esp in patients with high IL-6

Nationwide centralization in 🇯🇵 to improve research & quality of evidence
🔹Time to ECMO
🔹Lung compliance
🔹Biomarkers
3/9 GUIDANCE DOCUMENTS

Surviving Sepsis Guidelines
🔹VV ECMO for refractory hypoxemia despite optimizing ventilation rescue therapies & proning
🔹Intensive Care Med May 2020
doi:10.1007/s00134-020-06022-5
@AlhazzaniW

FDA Enforcement Policy expanded availability of devices
Read 9 tweets
#cardiotwitter -need help how would you manage this case. Attempting in 2 hours. EF normal and advanced Parkinson’s 68 yr old male @rwyeh @DKarmpaliotis @ajaykirtane @JAG24851 @mmamas1973
1- support no support 2-bifurcation strategy
Read 8 tweets
Thread on the reporting of hierarchical outcomes inspired by 1 of the only 2 #Impella RCTs.
A few months ago, @willsuh76 noted that rates of bleeding were not reported in PROTECT-II, a worry with any large bore percutaneous device.
This led me to look at the @FDA evaluation to see if they were reported there. I found it interesting that the FDA tables of outcomes/adverse events included all events, while the @CircAHA paper uses hierarchical for secondary outcomes.
Read 28 tweets

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