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Journal of Cardiovascular Translational Research

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Open Access 01-04-2019 | Original Article

Mechanical Unloading by Fulminant Myocarditis: LV-IMPELLA, ECMELLA, BI-PELLA, and PROPELLA Concepts

Authors: Carsten Tschöpe, Sophie Van Linthout, Oliver Klein, Thomas Mairinger, Florian Krackhardt, Evgenij V. Potapov, Gunther Schmidt, Daniel Burkhoff, Burkert Pieske, Frank Spillmann

Published in: Journal of Cardiovascular Translational Research | Issue 2/2019

Abstract

Mechanical circulatory support (MCS) is often required to stabilize patients with acute fulminant myocarditis with cardiogenic shock. This review gives an overview of the successful use of left-sided Impella in the setting of fulminant myocarditis and cardiogenic shock as the sole means of MCS as well as in combination with right ventricular (RV) support devices including extracorporeal life support (ECLS) (ECMELLA) or an Impella RP (BI-PELLA). It further provides evidence from endomyocardial biopsies that in addition to giving adequate support, LV unloading by Impella exhibits disease-modifying effects important for myocardial recovery (i.e., bridge-to-recovery) achieved by this newly termed “prolonged Impella” (PROPELLA) concept in which LV-IMPELLA 5.0, implanted via an axillary approach, provides support in awake, mobilized patients for several weeks. Finally, this review addresses the question of how to define the appropriate time point for weaning strategies and for changing or discontinuing unloading in fulminant myocarditis.

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Title: Mechanical Unloading by Fulminant Myocarditis: LV-IMPELLA, ECMELLA, BI-PELLA, and PROPELLA Concepts
Authors: Carsten Tschöpe
Sophie Van Linthout
Oliver Klein
Thomas Mairinger
Florian Krackhardt
Evgenij V. Potapov
Gunther Schmidt
Daniel Burkhoff
Burkert Pieske
Frank Spillmann
Publication date: 01-04-2019
Publisher: Springer US
Published in: Journal of Cardiovascular Translational Research / Issue 2/2019
Print ISSN: 1937-5387
Electronic ISSN: 1937-5395
DOI: https://doi.org/10.1007/s12265-018-9820-2

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Mechanical Unloading by Fulminant Myocarditis: LV-IMPELLA, ECMELLA, BI-PELLA, and PROPELLA Concepts

Abstract

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Abstract

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