title: Use of the AB5000 ventricular assist device in cardiogenic shock after acute myocardial infarction.
abstract: BACKGROUND
  The mortality rate of patients experiencing acute myocardial infarction (AMI) complicated by cardiogenic shock remains high. After conventional therapies have failed, ventricular assist devices (VADs) have been used to bridge patients to recovery or transplantation.
  
  
  METHODS
  A voluntary US registry was established to track all patients implanted with the AB5000 VAD. We report the results of the first 100 patients in the registry with the indication of AMI cardiogenic shock. Data were retrospectively reviewed for demographics, preimplant condition, surgical techniques, and outcomes. Survival was assessed at 30 days after VAD explant or at discharge. Myocardial recovery (subset of survival) was defined as satisfactory unassisted native cardiac function for 30 days after VAD explant or at discharge.
  
  
  RESULTS
  Forty patients (40%) survived to 30 days after VAD explant or discharge of the first 100 patients. Of the survivors, 63% (n = 25) experienced myocardial recovery. Patients who recovered required an average of 25 +/- 22 days of VAD support. The estimated survival after explant for the recovery patients at 2 years after VAD explant was 78%.
  
  
  CONCLUSIONS
  Results from this nationwide registry suggest that VADs can restore normal hemodynamics and support recovery of native cardiac function in the majority of survivors when conventional therapies fail. However, a longer duration of support than previously recognized may be required. In the absence of clinical guidelines, early aggressive use of VAD support in AMI complicated by cardiogenic shock may improve outcomes, and recovery of native cardiac function should always be the primary goal.
authors: Robert Wood Johnson Medical School, New Brunswick, New Jersey 08903, USA. andersm2@umdnj.edu
authors: Mark
authors: M
authors: Anderson
authors: Nicholas
authors: N
authors: Smedira
authors: Louis
authors: L
authors: Samuels
authors: Michael
authors: M
authors: Madani
authors: Yoshifumi
authors: Y
authors: Naka
authors: Michael
authors: M
authors: Acker
authors: Mariah
authors: M
authors: Hout
authors: Karim
authors: K
authors: Benali
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D012042:Registries; D012189:Retrospective Studies; D012770:Shock, Cardiogenic / Q000209:etiology* / Q000601:surgery*; D014481:United States