Avances en soporte circulatorio mecánico en el manejo del shock cardiogénico por Infarto Agudo de Miocardio
Keywords:
Cardiogenic shock, Impella, Acute myocardial infarction, Mechanical circulatory support, Ventricular assistance.Abstract
Cardiogenic shock (CS) due to acute myocardial infarction (AMI) is a critical condition requiring urgent intervention to restore perfusion and save the patient's life. In this context, mechanical circulatory support (MCS) technology has been pivotal, with Impella emerging as one of the most promising options. Impella is a ventricular assist device inserted percutaneously to provide hemodynamic support to the left ventricle, improving perfusion and reducing cardiac workload. Its use has proven effective in managing cardiogenic shock, especially in complicated AMI cases, improving mortality rates and recovery. This article discusses recent advancements in the use of Impella for CS management, addressing its clinical impact, indications, and future perspectives in modern cardiology.
Downloads
References
Krittanawong C, Khawaja M, Tamis‐Holland JE, Girotra S, Rao SV. Acute Myocardial Infarction: Etiologies and Mimickers in Young Patients. J Am Heart Assoc.2023[citado 05/05/2024];12(18):e029971. Disponible en:
https://pmc.ncbi.nlm.nih.gov/articles/PMC10547302/
Kapur NK, Thayer KL, Zweck E. Cardiogenic Shock in the Setting of Acute Myocardial Infarction. Methodist DeBakey Cardiovasc J.2020[citado 16/05/2025];16(1):16-21. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC7137623/
Munoz Tello C, Jamil D, Tran HHV, Mansoor M, Butt SR, Satnarine T, et al. The Therapeutic Use of Impella Device in Cardiogenic Shock: A Systematic Review. Cureus .2022[citado 16 /08/2025];14(10). Disponible en:
Zein R, Patel C, Mercado-Alamo A, Schreiber T, Kaki A. A Review of the Impella Devices. Interv Cardiol.2022[citado 16805/2025];17:e05. Disponible en:
https://www.icrjournal.com/articleindex/icr.2021.11
Siyab Panhwar M, Reed GW, Jain V, Ayoub A, Menon V, Lahorra JA, et al. Impella in Acute Myocardial Infarction Complicated by Cardiogenic Shock: History and Current Controversies. J Invasive Cardiol. 2022[citado 16/08/2025];34(10). Disponible en:
Schrage B, Schneider S, Uwe Zeymer U, Thiele H, Westermann D. Response by Schrage et al to Letter Regarding Article, "Impella Support for Acute Myocardial Infarction Complicated by Cardiogenic Shock: A Matched-Pair IABP-SHOCK II Trial 30-Day Mortality Analysis". Circulation.2019[citado 16/05/2025];140(11):559-560. Disponible en:
https://www.ahajournals.org/doi/epub/10.1161/CIRCULATIONAHA.119.041637
Basir MB, Lemor A, Gorgis S, Patel KC, Kolski BC, Bharadwaj AS, et al. Early Utilization of Mechanical Circulatory Support in Acute Myocardial Infarction Complicated by Cardiogenic Shock: The National Cardiogenic Shock Initiative. J Am Heart Assoc.2023[citado 03/01/2025];12(23):e031401. Disponible en:
https://www.ahajournals.org/doi/10.1161/JAHA.123.031401
Van Edom CJ, Gramegna M, Baldetti L, Beneduce A, Castelein T, Dauwe D, et al. Management of Bleeding and Hemolysis During Percutaneous Microaxial Flow Pump Support. JACC Cardiovasc Interv. 2023[citado 06/04/2025];16(14):1707-1720. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S1936879823009068
Møller JE, Gerke O. Danish-German cardiogenic shock trial—DanGer shock: Trial design update. Am Heart J.2023[citado 16/06/2025];255:90-93. Disponible en:
https://linkinghub.elsevier.com/retrieve/pii/S0002870322002733
Pepe M, Bortone AS, Giordano A, Cecere A, Burattini O, Nestola PL, et al. Cardiogenic Shock Following Acute Myocardial Infarction: What’s New? Shock.2020[citado 16/08/2025];53(4):391-399. Disponible en:
https://journals.lww.com/10.1097/SHK.0000000000001377
Karami M, Eriksen E, Ouweneel DM, Claessen BE, Vis MM, Baan J, et al. Long-term 5-year outcome of the randomized IMPRESS in severe shock trial: percutaneous mechanical circulatory support vs. intra-aortic balloon pump in cardiogenic shock after acute myocardial infarction. Eur Heart J Acute Cardiovasc Care.2021[citado 16/08/2025];10(9):1009-1015. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC8648392/
Attinger Toller A, Bossard M, Cioffi GM, Tersalvi G, Madanchi M, Bloch A, et al. Ventricular Unloading Using the ImpellaTM Device in Cardiogenic Shock. Front Cardiovasc Med. 2022[citado 16/08/2025];9:856870. Disponible en: https://www.frontiersin.org/articles/10.3389/fcvm.2022.856870/full
Henry TD, Tomey MI, Tamis-Holland JE, Thiele H, Rao SV, Menon V, et al. Invasive Management of Acute Myocardial Infarction Complicated by Cardiogenic Shock: A Scientific Statement From the American Heart Association. Circulation.2021 [citado 16/08/2025];143(15). Disponible en: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000959
Bogerd M, Ten Berg S, Peters EJ, Vlaar APJ, Engström AE, Otterspoor LC, et al. Impella and venoarterial extracorporeal membrane oxygenation in cardiogenic shock complicating acute myocardial infarction. Eur J Heart Fail.2023[citado 16/02/2024];25(11):2021-2031.Disponible en: https://onlinelibrary.wiley.com/doi/10.1002/ejhf.3025
Otero Escudero M. Estudio DanGer Shock: ¿evidencia a favor del Impella CP en el shock cardiogénico? . Cardiología hoy | Blog. Sociedad española de Cardiología.2024 [citado 16/02/2024]; Disponible en: https://secardiologia.es/blog/15124-estudio-danger-shock-evidencia-a-favor-del-ecmo-en-el-shock-cardiogenico
Gómez Hospital JA. Impella vs. balón de contrapulsación en IAM con shock: sin diferencias pero…Cardiología hoy | Blog. Sociedad española de Cardiología.2024 [citado 16/02/2024]; Disponible en: https://secardiologia.es/blog/8306-impella-vs-balon-de-contrapulsacion-en-iam-con-shock-sin-diferencias-pero
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 María Gabriela Balarezo García , Diego Armando Suárez Páez, David Nicolás Buenaño Carrillo
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
ACCESS AND DISTRIBUTION POLICY
All published articles are open access contributions, which are distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License which permits unrestricted non-commercial use, distribution and reproduction in any medium, provided that the primary source of publication is properly cited.
