PLoS ONE (Jan 2020)

Complications from percutaneous-left ventricular assist devices versus intra-aortic balloon pump in acute myocardial infarction-cardiogenic shock.

  • Saraschandra Vallabhajosyula,
  • Anna V Subramaniam,
  • Dennis H Murphree,
  • Sri Harsha Patlolla,
  • Lina Ya'Qoub,
  • Vinayak Kumar,
  • Dhiran Verghese,
  • Wisit Cheungpasitporn,
  • Jacob C Jentzer,
  • Gurpreet S Sandhu,
  • Rajiv Gulati,
  • Nilay D Shah,
  • Bernard J Gersh,
  • David R Holmes,
  • Malcolm R Bell,
  • Gregory W Barsness

DOI
https://doi.org/10.1371/journal.pone.0238046
Journal volume & issue
Vol. 15, no. 8
p. e0238046

Abstract

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BackgroundThere are limited data on the complications with a percutaneous left ventricular assist device (pLVAD) vs. intra-aortic balloon pump (IABP) in acute myocardial infarction-cardiogenic shock (AMI-CS).ObjectiveTo assess the trends, rates and predictors of complications.MethodsUsing a 17-year AMI-CS population from the National Inpatient Sample, AMI-CS admissions receiving pLVAD and IABP support were evaluated for vascular, lower limb amputation, hematologic, neurologic and acute kidney injury (AKI) complications. In-hospital mortality, hospitalization costs and length of stay in pLVAD and IABP cohorts with complications was studied.ResultsOf 168,645 admissions, 7,855 (4.7%) receiving pLVAD support. The pLVAD cohort had higher comorbidity, cardiac arrest (36.1% vs. 29.7%) and non-cardiac organ failure (74.7% vs. 56.9%) rates. Complications were higher in pLVAD compared to IABP cohort-overall 69.0% vs. 54.7%; vascular 3.8% vs. 2.1%; lower limb amputation 0.3% vs. 0.3%; hematologic 36.0% vs. 27.7%; neurologic 4.9% vs. 3.5% and AKI 55.4% vs. 39.1% (all pConclusionsAMI-CS admissions receiving pLVAD had higher rates of complications compared to the IABP, with worse in-hospital outcomes in the cohort with complications.