Concomitant Use of VA-ECMO and Impella Support for Cardiogenic Shock.

ECpella support is a feasible support strategy for allcomers in severe cardiogenic shock. This study demonstrates that ECpella can be utilized not only as a salvage therapy and venting strategy for those in cardiogenic shock on VA-ECMO, but also can be utilized as a method for additional cardiac support for patients with initial Impella support. There were no differences in survival between cardiogenic shock secondary to acute myocardial infarction and cardiogenic secondary to acute decompensated heart failure. Although ECpella patients that received initial Impella support have higher success in bridging to heart transplant, allcomers on ECpella support should be evaluated for advanced therapies early in their clinical course. Further studies are required to ascertain the differences in pathophysiology between cardiogenic shock secondary to acute myocardial infarction and cardiogenic secondary to acute decompensated heart failure and determine appropriate support strategies for differing cardiogenic shock phenotypes.