Skip to main content
Erschienen in: Herz 1/2017

07.12.2016 | Schwerpunkt

Linksventrikuläres Unloading im kardiogenen Schock

verfasst von: Prof. Dr. med. A. Schäfer, J. Bauersachs

Erschienen in: Herz | Ausgabe 1/2017

Einloggen, um Zugang zu erhalten

Zusammenfassung

Der kardiogene Schock ist ein akut lebensbedrohender Zustand, bei dem es zu einer Einschränkung der Organdurchblutung und -oxygenierung kommt. Eine invasive Beatmung sowie Kreislaufunterstützung mit Katecholaminen sind zur Stabilisierung meistens unvermeidbar, aber mit stark reduzierter Langzeitprognose verbunden. Da häufig eine medikamentöse Stabilisierung nicht erfolgreich ist, wurden zur Kreislaufunterstützung mechanische Systeme entwickelt, die die linke Herzkammer entlasten, um eine Erholung des Herzens zu ermöglichen oder Zeit bis zur definitiven Therapie zu gewinnen. Diese Systeme werden mittlerweile in vielen großen Zentren vorgehalten und eingesetzt.
Literatur
1.
Zurück zum Zitat Aqel RA, Hage FG, Iskandrian AE (2010) Improvement of myocardial perfusion with a percutaneously inserted left ventricular assist device. J Nucl Cardiol 17:158–160CrossRefPubMed Aqel RA, Hage FG, Iskandrian AE (2010) Improvement of myocardial perfusion with a percutaneously inserted left ventricular assist device. J Nucl Cardiol 17:158–160CrossRefPubMed
2.
Zurück zum Zitat Windecker S, Kolh P et al (2014) 2014 ESC/EACTS Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J 35:2541–2619CrossRefPubMed Windecker S, Kolh P et al (2014) 2014 ESC/EACTS Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J 35:2541–2619CrossRefPubMed
3.
Zurück zum Zitat Bauersachs J, Arrigo M, Hilfiker-Kleiner D et al (2016) Current management of patients with severe acute peripartum cardiomyopathy: practical guidance from the Heart Failure Association of the European Society of Cardiology Study Group on peripartum cardiomyopathy. Eur J Heart Fail 18:1096–1105CrossRefPubMed Bauersachs J, Arrigo M, Hilfiker-Kleiner D et al (2016) Current management of patients with severe acute peripartum cardiomyopathy: practical guidance from the Heart Failure Association of the European Society of Cardiology Study Group on peripartum cardiomyopathy. Eur J Heart Fail 18:1096–1105CrossRefPubMed
4.
Zurück zum Zitat Burkhoff D (2015) Device therapy: Where next in cardiogenic shock owing to myocardial infarction? Nat Rev Cardiol 12:383–384CrossRefPubMed Burkhoff D (2015) Device therapy: Where next in cardiogenic shock owing to myocardial infarction? Nat Rev Cardiol 12:383–384CrossRefPubMed
5.
Zurück zum Zitat Burkhoff D, Sayer G, Doshi D et al (2015) Hemodynamics of mechanical circulatory support. J Am Coll Cardiol 66:2663–2674CrossRefPubMed Burkhoff D, Sayer G, Doshi D et al (2015) Hemodynamics of mechanical circulatory support. J Am Coll Cardiol 66:2663–2674CrossRefPubMed
6.
Zurück zum Zitat Hochman JS, Sleeper LA, Webb JG et al (1999) Early revascularization in acute myocardial infarction complicated by cardiogenic shock. SHOCK Investigators. Should we emergently revascularize occluded coronaries for cardiogenic shock. N Engl J Med 341:625–634CrossRefPubMed Hochman JS, Sleeper LA, Webb JG et al (1999) Early revascularization in acute myocardial infarction complicated by cardiogenic shock. SHOCK Investigators. Should we emergently revascularize occluded coronaries for cardiogenic shock. N Engl J Med 341:625–634CrossRefPubMed
7.
Zurück zum Zitat Kapur NK, Qiao X, Paruchuri V et al (2015) Mechanical pre-conditioning with acute circulatory support before reperfusion limits infarct size in acute myocardial infarction. JACC Heart Fail 3:873–882CrossRefPubMed Kapur NK, Qiao X, Paruchuri V et al (2015) Mechanical pre-conditioning with acute circulatory support before reperfusion limits infarct size in acute myocardial infarction. JACC Heart Fail 3:873–882CrossRefPubMed
8.
Zurück zum Zitat O’gara PT, Kushner FG, Ascheim DD et al (2013) 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 127:e362–e425CrossRefPubMed O’gara PT, Kushner FG, Ascheim DD et al (2013) 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 127:e362–e425CrossRefPubMed
9.
Zurück zum Zitat O’neill WW, Kleiman NS, Moses J et al (2012) A prospective, randomized clinical trial of hemodynamic support with Impella 2.5 versus intra-aortic balloon pump in patients undergoing high-risk percutaneous coronary intervention: the PROTECT II study. Circulation 126:1717–1727CrossRefPubMed O’neill WW, Kleiman NS, Moses J et al (2012) A prospective, randomized clinical trial of hemodynamic support with Impella 2.5 versus intra-aortic balloon pump in patients undergoing high-risk percutaneous coronary intervention: the PROTECT II study. Circulation 126:1717–1727CrossRefPubMed
10.
Zurück zum Zitat O’neill WW, Schreiber T, Wohns DH et al (2014) The current use of Impella 2.5 in acute myocardial infarction complicated by cardiogenic shock: results from the USpella Registry. J Interv Cardiol 27:1–11CrossRefPubMed O’neill WW, Schreiber T, Wohns DH et al (2014) The current use of Impella 2.5 in acute myocardial infarction complicated by cardiogenic shock: results from the USpella Registry. J Interv Cardiol 27:1–11CrossRefPubMed
11.
Zurück zum Zitat Ostadal P, Mlcek M, Kruger A et al (2015) Increasing venoarterial extracorporeal membrane oxygenation flow negatively affects left ventricular performance in a porcine model of cardiogenic shock. J Transl Med 13:266CrossRefPubMedPubMedCentral Ostadal P, Mlcek M, Kruger A et al (2015) Increasing venoarterial extracorporeal membrane oxygenation flow negatively affects left ventricular performance in a porcine model of cardiogenic shock. J Transl Med 13:266CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Ponikowski P, Voors AA, Anker SD et al (2016) 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 37:2129–2200CrossRefPubMed Ponikowski P, Voors AA, Anker SD et al (2016) 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 37:2129–2200CrossRefPubMed
13.
Zurück zum Zitat Rihal CS, Naidu SS, Givertz MM et al (2015) 2015 SCAI/ACC/HFSA/STS clinical expert consensus statement on the use of percutaneous mechanical circulatory support devices in cardiovascular care: Endorsed by the American Heart Assocation, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencion; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie d’intervention. J Am Coll Cardiol 65:e7–e26CrossRefPubMed Rihal CS, Naidu SS, Givertz MM et al (2015) 2015 SCAI/ACC/HFSA/STS clinical expert consensus statement on the use of percutaneous mechanical circulatory support devices in cardiovascular care: Endorsed by the American Heart Assocation, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencion; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie d’intervention. J Am Coll Cardiol 65:e7–e26CrossRefPubMed
14.
Zurück zum Zitat Schäfer A, Berliner D, Sieweke JT, Bauersachs J (2016) Outcome after implntation of an ImpellaCP microaxial-flow pump in patients with cardiogenic shock. EuroPCR, 2016. Schäfer A, Berliner D, Sieweke JT, Bauersachs J (2016) Outcome after implntation of an ImpellaCP microaxial-flow pump in patients with cardiogenic shock. EuroPCR, 2016.
15.
Zurück zum Zitat Thiele H, Ohman EM, Desch S et al (2015) Management of cardiogenic shock. Eur Heart J 36:1223–1230CrossRefPubMed Thiele H, Ohman EM, Desch S et al (2015) Management of cardiogenic shock. Eur Heart J 36:1223–1230CrossRefPubMed
16.
Zurück zum Zitat Thiele H, Zeymer U, Werdan K (2013) Intraaortic balloon support for cardiogenic shock. N Engl J Med 368:81CrossRefPubMed Thiele H, Zeymer U, Werdan K (2013) Intraaortic balloon support for cardiogenic shock. N Engl J Med 368:81CrossRefPubMed
Metadaten
Titel
Linksventrikuläres Unloading im kardiogenen Schock
verfasst von
Prof. Dr. med. A. Schäfer
J. Bauersachs
Publikationsdatum
07.12.2016
Verlag
Springer Medizin
Erschienen in
Herz / Ausgabe 1/2017
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI
https://doi.org/10.1007/s00059-016-4512-7

Weitere Artikel der Ausgabe 1/2017

Herz 1/2017 Zur Ausgabe

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.