PCWP PRESSURE TRIAL

Furthermore, a recent analysis of the SHOCK Trial and Registry identified that 45 and 38% of patients would have met hemodynamic inclusion criteria for RVF in the RR Trial. The Impella RP post-approval study demonstrated improved survival among patients receiving the Impella RP who met the pre-market IDE RR inclusion criteria for RVF compared to those who did not meet these criteria and received the device as a salvage procedure. RVF in the RR Trial was defined as a cardiac index 15 mmHg, CVP-to-pulmonary capillary wedge pressure (PCWP) ratio >0.63, or moderate to severe global RV dysfunction ( 3). The Recover Right (RR) Trial demonstrated the safety and potential efficacy of the Impella RP, a rapidly deployed percutaneous RV assist device, in the setting of cardiogenic shock.

The role for CVP in the setting of short-term mechanical circulatory support is less well-characterized. Increased central venous pressure (CVP) measured before or during surgical left ventricular assist device (LVAD) support is a well-established clinical indicator of risk for RVF ( 2). In these patients, early identification of RVF and deployment of temporary RV support may improve outcomes. Right ventricular failure (RVF) after myocardial infarction, cardiotomy, or left-sided mechanical support is associated with increased morbidity and mortality ( 1). 7.14 events, p = 0.067).Ĭonclusion: CVP is a single, readily accessible hemodynamic parameter which predicts a higher rate of short-term mortality and may identify subclinical RVF in patients receiving LV-MCS for cardiogenic shock. LV-MCS suction events were non-significantly more frequent among patients with high vs. CVP remained significantly associated with in-hospital mortality even after adjustment in a multivariable model (adjusted OR 1.10 per 1 mmHg increase). 11.7 mmHg, p = 0.014), and a CVP >12 identified patients at significantly higher risk for in-hospital mortality (65 vs. Results: CVP was significantly higher among patients who died in the hospital (14.0 vs. A total of 132 patients with a documented CVP measurement while on Impella left-sided support for cardiogenic shock were identified. Methods: Between January 2014 and June 2019, we analyzed hemodynamic parameters during Impella LV-MCS from 28 centers in the United States participating in the global, prospective catheter-based ventricular assist device (cVAD) study. Objectives: We studied whether elevated CVP during LV-MCS for acute myocardial infarction complicated by cardiogenic shock is associated with higher mortality. Increased central venous pressure (CVP) is an indicator of potential RVF. 5Henry Ford Health System, Detroit, MI, United Statesīackground: Right ventricular failure (RVF) is associated with increased mortality among patients receiving left ventricular mechanical circulatory support (LV-MCS) for cardiogenic shock and requires prompt recognition and management.4Duke Medical Center, Durham, NC, United States.3New York-Presbyterian, Advanced Heart Failure and Cardiac Transplant, New York, NY, United States.2Cardiovascular Research Foundation, New York, NY, United States.1Tufts Medical Center, Cardiovascular Center for Research and Innovation, Boston, MA, United States.Magnus Ohman 4, William O'Neill 5 and Navin K. Thayer 1, Daniel Burkhoff 2, Nir Uriel 3, E.

Pcwp pressure