Podcasts about Impella

In dieser Folge geht es um lebensrettenden Maschinenbau im Miniaturformat. Sarah und Marco begrüßen den Gewinner des diesjährigen Aachener Ingenieurpreises, Dr. Thorsten Sieß vom Aachener Unternehmen Abiomed, der für seine Entwicklung der kleinsten Herzpumpe der Welt ausgezeichnet wird, und sprechen mit ihm über den Weg zu seiner lebensrettenden Innovation.

One unstable patient, three departments, and every nurse on alert... Let's break down what really happens during a high-risk STEMI. This episode follows the case of a 62-year old patient from ER to the Cath Lab to the ICU. Nurses Sarah Vance and Caitlyn Nichols help us explore the role of nurses in each stage of care, from stabilizing the patient to placing an Impella device.We cover everything from IV placement and medications to monitoring patients through each phase of care. Learn how to prepare patients for the Cath Lab, manage complications like V-fib and bleeding post-PCI, and support the next team during handoffs. This is a must-listen for nurses involved in cardiac care!Topics discussed in this episode:Case presentation of a 62-year old patientER nurse priorities for STEMI patientsInitial treatment and stabilizationWhy “M.O.N.A.” is an outdated practicePreparing the patient for the Cath Lab teamCath Lab nurse responsibilities and role during PCIHigh-risk PCI vs. standard PCIManaging common complicationsTransitioning from Cath Lab to ICUICU nurse priorities for post-PCI patientsImpella placement and monitoringManaging reperfusion arrhythmiasLong-term care and getting patients off the ImpellaPatient and family educationConnect with Sarah Vance:https://www.instagram.com/iseeu_nurse/Connect with Caitlyn Nichols:https://www.instagram.com/icunursingnotesbycaitlyn/Mentioned in this episode:CONNECT

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Daniel Goldstein, professor and vice chairman of Montefiore Health System in New York, USA, about the importance of mentorship. Chapters 00:00 Intro 03:24 JANS 1, Cardiac 05:42 JANS 2, General 08:40 JANS 3, Cardiac 12:17 JANS 4, General 13:45 JANS 5, Cardiac 14:53 Video 1, Cardiac 16:48 Video 2, Thoracic 18:53 Video 3, Cardiac 20:29 Dr. Goldstein Interview 33:06 Closing They explore how to be an effective mentor, outlining essential steps in mentoring and the process of developing great surgeons. They also discuss the significance of volunteering and contributing to advance within the field. Additionally, they cover the incentives of being a good mentor, provide advice for trainees currently seeing to join a program, and delve into how and why Dr. Goldstein was selected by the ISHLT Foundation to receive the 2025 Francis D. Pagani, MD, Endowed Mentorship Award. In a separate segment, Joel addresses minimally invasive surgery in Europe.   Joel also highlights recent JANS articles on lifetime management of heart valve disease, social media use among cardiothoracic surgeons, a surgeon's tool kit for mitral valve-induced left ventricular outflow tract obstruction with minimal septal hypertrophy, transatlantic analysis of gender representation in general thoracic surgery, and extent of coronary artery disease and clinical outcomes with ticagrelor monotherapy vs aspirin after coronary artery bypass grafting.  In addition, Joel explores an infarct exclusion technique for posterior ischemic ventricular septal defect in a patient with Impella 5.5 support, mastering robotic lung resection using the French lobectomy technique for standardized surgical education, and assessment, debridement, and annular support for valve replacement in a case of mitral annular calcification. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Lifetime Management of Heart Valve Disease—Treat It Early and Treat It Right, First Time  2.) Social Media Use Among Cardiothoracic Surgeons: The Online Landscape and Comparisons Between Subgroups  3.) A Surgeon's Toolkit for Mitral Valve-Induced Left Ventricular Outflow Tract Obstruction With Minimal Septal Hypertrophy  4.) Trans-Atlantic Analysis of Gender Representation in General Thoracic Surgery: Challenges Permeate the Academic Community  5.) Extent of Coronary Artery Disease and Clinical Outcomes With Ticagrelor Monotherapy Versus Aspirin After Coronary Artery Bypass Grafting: Insights From the TiCAB Trial  CTSNET Content Mentioned  1.) Infarct Exclusion Technique for Posterior Ischemic Ventricular Septal Defect in a Patient With Impella 5.5 Support  2.) Mastering Robotic Lung Resection: The French Lobectomy Technique for Standardized Surgical Education  3.) Mitral Annular Calcification: Assessment, Debridement, and Annular Support for Valve Replacement  Other Items Mentioned  1.) Cardiac Surgical Arrest—An International Conversation, Part 3  2.) Career Center   3.) CTSNet Events Calendar  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

New Insights from the DanGer Shock Trial!

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. David Kalfa, the incoming Chief of Pediatric Cardiac Surgery and Co-Director of the Heart Institute at Nicklaus Children's Hospital in Miami, about allogeneic mitral valve transplants. Chapters 00:00 Intro 01:46 Interview Preview 02:54 MV Surgery After Failed Intervention 07:46 Tears Predict Outcomes After Hemi-Arch 10:32 Pain Catastrophizing Scale 14:27 ARR w Stentless Biopros, Sex Difference 16:38 Open Implant TAV via Redo Sternotomy 19:05 Repeat Sternotomy w Completion Unifocaliz 21:07 Direct Aortic Impella 5.5 in PC Shock 25:16 Dr. Kalfa Interview, AMV Transplant 39:58 Upcoming Events 41:26 Closing They discuss methods for obtaining a mitral valve for transplantation, and topics such as immunosuppression, aortic coagulation, and the progress that has been made in this field. They also explore how to perform a living allogeneic heart valve transplant and the future of this technique.   Joel also highlights recent JANS articles on mitral valve surgery after failed transcatheter intervention for mitral regurgitation, whether distal anastomotic new entry tears predict long-term outcomes after hemiarch repair for DeBakey I aortic dissection, using a pain catastrophizing scale as a predictor for acute postoperative pain following video-assisted thoracoscopic surgery lobectomy, and sex difference in aortic root replacement with a stentless bioprosthesis.  In addition, Joel explores an open implantation of a transcatheter aortic valve via redo sternotomy, mitral valve replacement, and tricuspid valve repair in a high-risk patient, repeat sternotomy with completion unifocalization and extensive pulmonary arterial reconstruction in ToF/PA/MAPCAs, and direct aortic Impella 5.5 in post-cardiotomy shock. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Mitral Valve Surgery After Failed Transcatheter Intervention for Mitral Regurgitation: Techniques, Challenges, and Outcomes  2.) Distal Anastomotic New Entry Tears Predict Long-Term Outcomes After Hemi-Arch Repair for DeBakey I Aortic Dissection  3.) Pain Catastrophizing Scale as a Predictor for Acute Postoperative Pain Following Video-Assisted Thoracoscopic Surgery Lobectomy  4.) Sex Difference in Aortic Root Replacement With a Stentless Bioprosthesis  CTSNET Content Mentioned  1.) Open Implantation of a Transcatheter Aortic Valve via Redo Sternotomy, Mitral Valve Replacement, and Tricuspid Valve Repair in a High-Risk-Patient  2.) Challenging Pulmonary Arterial Reconstruction: Repeat Sternotomy With Completion Unifocalization and Extensive Pulmonary Arterial Reconstruction in ToF/PA/MAPCAs   3.) Direct Aortic Impella 5.5 in Post-Cardiotomy Shock  Other Items Mentioned  1.) Allogeneic Mitral Valve Transplant: Historical Precedent, Current Considerations, and Future Implementation  2.) Cardiac Surgical Arrest—An International Conversation, Part 1  3.) Winners of the 2025 CTSNet Instructional Video Competition  4.) Career Center   5.) CTSNet Events Calendar  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

In this debut episode of JACC This Week with Editor-in-Chief Dr. Harlan Krumholz, we explore groundbreaking studies and timely insights from the July 1st issue. Highlights include the impact of wildfire smoke on heart failure risk, new hemodynamic data on mechanical circulatory support in cardiogenic shock, and sobering cardiovascular mortality trends over the past 25 years. Plus, updates on aspirin use, cognitive impairment in CVD, ACC/AHA performance measures, and a leadership reflection from ACC President Dr. Christopher Kramer.

Integrating POCUS into transport protocols can revolutionize patient care and outcome in criticalcare scenarios. Today, host Shane Turner sits down with flight paramedic Isaac Bennett toexplore the critical role of point-of-care ultrasound (POCUS) in the management of Impellasupported patients during transport. With 14 years of EMS experience, including 7 years flying with the Hospital Wing program based in Memphis, Isaac shares his expert insights on howPOCUS can guide Impella positioning, monitor volume status, and troubleshoot alarms effectively, even in challenging pre-hospital environments.Plus, they discuss practical techniques for obtaining clear cardiac views and the importance oflandmarks and regular practice. This episode is a must-listen for transport clinicians looking to enhance their diagnostic capabilities and improve patient outcomes with POCUS.In this episode:Shane Turner, RN, CFRN, NRP, FP-C, CMTE, Chattanooga, TN, AbiomedIsaac Bennett, Flight Paramedic, Memphis Tennessee

In this second installment of our Data Deep Dive, Shane Turner reconnects with Ken Kasica, who specializes in cardiovascular pharmacology at Abiomed. The two dissect the complex interactions between drug therapies and the Impella heart pumps in critical care. Learn about the impact of vasoconstrictive drugs such as levosimendan and norepinephrine on Impella performance, and studies that highlight the risks associated with high doses of inotropes and vasopressors. This episode provides essential insights for transport clinicians on managing patients with these medications, including strategies from heart teams at destination centers for device escalation, and the latest advancements in the field.In this episode:Shane Turner, RN, CFRN, NRP, FP-C, CMTE, Chattanooga, TN, AbiomedKen Kasica, PharmD, MBA, Director, Scientific Intelligence, Abiomed

Teaching best practices for transporting Impella patients is something Zac Bunzey handles every day. As a clinical education manager at Life Flight Network, Zac joins Shane Turner to share how targeted training campaigns, hands-on experience, and tools like the Impella app, combined with Abiomed's 24/7 support, have markedly boosted crew confidence and proficiency.Plus, you'll learn about the importance of cognitive aids and routine practice with low-frequency events to maintain skills. Whether you're experienced in Impella transports or new to the process, this episode offers crucial strategies to enhance your crew's readiness and effectiveness in managing these critical patients.In this episode:Shane Turner, RN, CFRN, NRP, FP-C, CMTE, Chattanooga, TNZac Bunzey, Clinical Education Manager, Life Flight Network

Are you equipped to handle cardiogenic shock? In this episode, you'll gain insights from an expert on the frontlines about the complexities of caring for these critical patients and how you can excel in providing world-class critical care transport.Shane Turner sits down with Dr. Adam Gottula, an emergency physician and critical care intensivist from Methodist Hospital in San Antonio, Texas. They discuss the management of cardiogenic shock in transport settings, the crucial role of a multidisciplinary approach, and the latest strategies for improving patient outcomes.Dr. Gottula shares the importance of cognitive checklists, standardized patient classification, and the life-saving role of the Impella device during transport. Plus, essential practices for optimizing outcomes in patients with Impella support during cardiac arrest, including the critical steps of prompt CPR and correct device positioning.Shane Turner, RN, CFRN, NRP, FP-C, CMTE, Chattanooga, TNAdam Gottula, M.D., San Antonio, Texas

In this episode, Dr. Valentin Fuster dives into the complex and high-stakes world of cardiogenic shock, spotlighting new clinical trials, expert consensus guidance, and cutting-edge insights from machine learning. From evaluating the impact of intra-aortic balloon pumps to rethinking mechanical support strategies, the episode delivers a powerful update on one of cardiology's most urgent challenges.

In today's episode of the Legal Nurse Podcast, we delve into the life-saving world of cardiac stents with expert cardiologist Joshua Willis. Discover the evolution of stents, from their inception to their transformative role in treating heart disease. Joshua shares insights into the critical procedures that follow stent insertion and navigates the complexities of balancing patient care with available resources. You'll discover how these medical advancements have changed lives and the collaborative decision-making involved in this vital field. Tune in and explore the fascinating journey of cardiac care! Heart Procedures: Cardiac Stents and Beyond Addresses these Questions: Join us for this episode, during which we discuss these questions. How did the concept of cardiac stents develop, and who was a key figure in their development? What are the differences between bare metal stents and drug-eluting stents, and how do they function in preventing coronary artery blockages? What are the typical medications used post-stent insertion to prevent clot formation, and why are they crucial? How does the radial approach differ from the femoral approach in cardiac procedures, and why has it become more favored? What role does shared governance play in deciding between stent insertion and coronary artery bypass surgery for a patient? Listen to our podcasts or watch them using our app, Expert.edu, available at legalnursebusiness.com/expertedu. Get the free transcripts and also learn about other ways to subscribe. Go to Legal Nurse Podcasts subscribe options by using this short link: http://LNC.tips/subscribepodcast. Are you finding it tough to Grow Your LNC Business? You are not alone! Join us for the 12th LNC SUCCESS® 3-DAY ONLINE CONFERENCE on November 13, 14, & 15, 2025! It's a chance to learn how to overcome common challenges and gain the skills you need to succeed in legal nurse consulting. Connect with industry experts who will share practical strategies for standing out, building strong relationships with attorneys, and effectively presenting your value. No matter your experience level, this conference will empower you to discover fresh opportunities and advance your business. What to Expect Expert-Led Sessions: Engage with sessions led by top industry professionals. Interactive Workshops: Participate in hands-on workshops designed to enhance your consulting skills. Networking Opportunities: Build lasting connections with peers and potential clients. Resource Materials: Receive exclusive materials that will support your ongoing professional development. Don't miss this chance to make a real impact on your business. Register Today Secure your spot at the 12th LNC SUCCESS® 3-DAY ONLINE CONFERENCE on November 13, 14, & 15, 2025, and take your first step toward becoming a leading legal nurse consultant! We look forward to welcoming you to this pivotal event in February 2025! Your Presenter for Heart Procedures: Cardiac Stents and Beyond Joshua M Willis, MD Dr. Willis completed a cardiology fellowship at the Cleveland Clinic Foundation (2007-2010) and an Interventional Cardiology fellowship at the University of Florida (2010-2011).       In 2011, he took a private cardiology practice job in Chattanooga, Tennessee, splitting his time between hospital-based procedures (cardiac catheterizations, percutaneous coronary interventions, Swan Ganz catheterization for invasive hemodynamic measurements, Impella device placement etc.) and clinic duties, and seeing approximately 24-26 patients per full clinic day. His job responsibilities at Wellstar include three days in the hospital, providing Interventional and General Cardiology coverage and 1.5 days in clinic seeing outpatients, total of 35-40 outpatient visits per week. Connect with Joshua M Willis, MD by email at cardioexpertwitness@gmail.com,

Today we're going ‘back to basics' with Austin Provence, a cardiothoracic nurse who brings a decade of experience in transporting patients with Impella devices and the importance of seamless teamwork. With over a decade of experience, Austin highlights two critical scenarios: stable patients needing higher care and critically ill patients requiring immediate interventions. He underscores the importance of mastering proper Impella placement and management, noting that a significant portion of these patients may present additional health challenges.Austin shares practical tips on maintaining the correct angle to prevent bleeding, managing sedation, and ensuring clear communication between hospital and transport teams. This episode is packed with best practices and strategies to enhance the competency and confidence of transport clinicians in handling complex cardiac cases.In this episode:Shane Turner, RN, CFRN, NRP, FP-C, CMTE, Chattanooga, TNAustin Provence, Hospital Wing Flight Nurse

In this episode, recorded live at the Critical Care Canada Forum in Toronto, we dive into extracorporeal life support (ECLS) in cardiogenic shock, with Dr Sean van Diepen. He is an Associate Professor at the University of Alberta, Co-Director of the CCU at the Mazankowski Alberta Heart Institute, and a leading voice in cardiac critical care. Join us as we explore the evolving landscape of mechanical circulatory support, the latest evidence from the DANGER and ECLS-SHOCK trials, and the complexities of patient selection. Key Topics Covered:1. The Evolution of ECLS in Cardiogenic Shock • The 25-year gap since the last positive cardiogenic shock trial. • How mechanical circulatory support expanded despite limited evidence.2. The DANGER Trial – Impella in AMI-Associated Cardiogenic Shock • Mechanism and function of the Impella device. • Trial results: 20% mortality reduction at 180 days. • Complications: Limb ischemia, hemolysis, and high costs. • Real-world application: Who actually qualifies?3. ECLS-SHOCK Trial – ECMO for Cardiogenic Shock • A "negative" trial, but a crucial wake-up call. • No mortality benefit but significantly higher complication rates. • Controversies: Inclusion of cardiac arrest patients and transition to destination therapy. • Future directions: Can patient selection improve outcomes?4. ECPR – Extracorporeal Support in Refractory Cardiac Arrest • Review of the ARREST, PRAGUE, and INCEPTION trials. • Why the evidence remains unclear and institution-dependent. • The role of high-volume ECMO centers and standardized pathways.5. The Future of ECLS – Cost, Ethics, and Decision-Making • How should institutions decide who gets ECMO? • The role of cardiogenic shock teams. • Could AI play a role in decision-making? • The challenge of resource allocation in a single-payer system.Key Takeaways:✅ Impella shows promise in carefully selected AMI shock patients but is costly and high-risk.✅ ECMO for cardiogenic shock remains controversial—patient selection is key.✅ ECPR is promising but needs further trials and structured implementation.✅ Cardiogenic shock management should be a team decision, not an individual one.

Cardiogenic shock is a devastating condition with a persistent 50% mortality rate. However, groundbreaking treatments and technologies are now dramatically improving survival odds. Join Shane Turner as he sits down with Jason Weatherly, Cardiogenic Shock Commercial Marketing Manager at Abiomed, to explore these advancements and the life-saving impact of the Impella device.Jason highlights the recent DanGer Shock RCT, which confirmed that Impella CP® with SmartAssist® improves survival by 12.7%. Together, they delve into how these medical breakthroughs are crucially linked to critical care transport, emphasizing innovative strategies that are essential for enhancing patient outcomes and shaping the future of cardiogenic shock treatment.In this episode:Shane Turner, RN, CFRN, NRP, FP-C, CMTE, Chattanooga, TNJason Weatherly, Cardiogenic Shock Commercial Marketing Manager at Abiomed

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Husam Balkhy, Professor of Surgery and the Director of Robotic and Minimally Invasive Cardiac Surgery at University of Chicago Medicine and President of The International Society for Minimally Invasive Cardiothoracic Surgery (ISMICS), about robotic totally endoscopic cardiac surgery procedures. They discuss potential ways to get the world to perform more robot-assisted surgeries, the building blocks to learning robotics, the future of learning robotics, and what to expect this year at the ISMICS 2025 Annual Meeting. They also explore Dr. Balkhy's new President's Series on CTSNet and provide insights into the first video of this series. Joel also highlights some of the videos in the CTSNet Resident Video Competition and the robotics vs VATS debate in Britain.   Joel also reviews recent JANS articles on the impact of restricted chests on long-term lung function parameters following lung transplantation in patients with interstitial lung disease, determinants of inadequate cardioprotection in adult patients with left ventricular dysfunction, engineered heart muscle allografts for heart repair in primates and humans, and risk factor analysis for 30-day mortality after surgery for infective endocarditis.  In addition, Joel explores open repair of descending thoracic and thoracoabdominal aortic aneurysms, totally 3D endoscopic third tricuspid valve replacement, and how to use the Impella for on-pump CABG in patients with low EF. Before closing, he highlights upcoming events in CT surgery.   JANS Items Mentioned  1.) The Impact of Restricted Chests on Long-Term Lung Function Parameters Following Lung Transplantation in Patients With Interstitial Lung Disease    2.) Determinants of Inadequate Cardioprotection in Adult Patients With Left Ventricular Dysfunction  3.) Engineered Heart Muscle Allografts for Heart Repair in Primates and Humans  4.) Risk Factor Analysis for 30-Day Mortality After Surgery for Infective Endocarditis   CTSNET Content Mentioned  1.) Open Repair of Descending Thoracic and Thoracoabdominal Aortic Aneurysms  2.) Totally 3D Endoscopic Third Tricuspid Valve Replacement  3.) ICC 2024 | How I Use the Impella for On-Pump CABG in Patients With Low EF: Insertion, Intraoperative Management, and Weaning/Removal  Other Items Mentioned  1.) President's Series With Husam Balkhy | ISMICS President   2.) ISMICS 2025 Annual Meeting   3.) Career Center   4.) CTSNet Events Calendar  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

This is part two of a two part program covering some of the most listened to pieces we've done in the last 12 months. We'd love you to check out part 1, which is here: https://topmedtalk.libsyn.com/annual-digest-part-1-topmedtalk In this piece we cover and reflect upon the following podcasts: "The evolution of the Impella device in anesthesia, critical care, and perioperative medicine” https://topmedtalk.libsyn.com/the-evolution-of-the-impella-device-in-anesthesia-critical-care-and-perioperative-medicine-anes24 Is Trauma Informed Care part of your perioperative process? https://topmedtalk.libsyn.com/is-trauma-informed-care-part-of-your-perioperative-process-topmedtalk ROCKet Trial and PANDOS | Euroanaesthesia 2024 https://topmedtalk.libsyn.com/rocket-trial-and-pandos-tmt-at-ea24 "Patient Safety and Quality: New Standards in Anesthesia | #ANES24" https://topmedtalk.libsyn.com/patient-safety-and-quality-new-standards-in-anesthesia-anes24 And “Perioperative medicine in focus | EBPOM 24” https://topmedtalk.libsyn.com/perioperative-medicine-in-focus-ebpom-24

How does continuous learning and practical experience on the front lines make a difference in transport? Today's episode is hosted by critical care transport trainer, Jena Billig, who sits down with Josh Klute, an expert flight and ICU nurse, who credits specialized Impella training with his confidence and success in transport. Josh recounts his initial challenges and lack of confidence during his first Impella transport, contrasting it with the marked improvement in his skills and confidence after receiving targeted training. Jena and Josh discuss the necessity of continuous education and the value of tailored training in empowering transport teams, ultimately enhancing patient care and provider confidence.In this episode:Jena Billig, BSN, RN, CCRN, CFRN, Idaho Springs, ColoradoJosh Klute, EMT, Colorado Springs, Colorado

In this podcast, Dr. Valentin Fuster discusses a study on the use of the microaxial flow pump (Impella) in treating older patients with cardiogenic shock following a myocardial infarction. The findings suggest that while the Impella pump can reduce mortality in younger patients, its effectiveness diminishes in those over 77, highlighting the need for age-based patient selection to optimize outcomes in this complex condition.

Impella devices can be game-changers for cardiogenic shock, and members of the care team who manage these patients during transport require specific training and skills to optimize patient outcomes. Today, host Shane Turner is joined by Ryan Harmon to take an inside look at the systematic approach one clinician uses to troubleshoot issues and optimize these advanced therapies. Ryan Harmon is a clinical care coordinator in the emergency room with extensive experience as both a nurse and a paramedic.Harmon emphasizes the need for a systematic approach to troubleshooting issues, such as preload, afterload, and positioning, and the importance of managing medications to avoid complications. You'll also learn the value of having a knowledgeable partner and being prepared for potential challenges during transports.In this episode:Shane Turner, RN, CFRN, NRP, FP-C, CMTE, Chattanooga, TNRyan Harmon, Critical Care Transport Nurse/Paramedic, Lebanon, OH

Dr. Trina Augustin, assistant professor of both anesthesiology and perioperative medicine as well as emergency medicine takes us on a deep dive into the care of persons with aortic stenosis. In this chapter, Alex and Venk learn about how to use ultrasound to diagnose AS, the keys to resuscitation, the pathophysiology of this condition, as well as the value of consultative services and the potential interventions that they may unlock for these patients. Kickoff season 4 with this in depth reminder that sometimes the heart has many hidden perils beyond ACS.  CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch; @KatrinaJoyAugustin Email - AlwaysOnEM@gmail.com REFERENCES & LINKS Lichtenstein DA, Meziere GA. Relevance of Lung Ultrasound in the Diagnosis of Acute Respiratory Failure. Chest 2008; 134:117-125 Walsh MH, Smyth LM, Desy JR, Fischer EA, Goffi A, Li N, Lee M, St-Pierre J, Ma IWY. Lung Ultrasound: A Comparison of image interpretation accuracy between curvillinear and phased array transducers. Australia J Ultrasound Med, 26:150-156 Alzahrani H, Woo MY, Johnson C, Pageau P, Millington S, Thiruganasambandamoorthy V. Can severe aortic stenosis be identified by emergency physicians when interpreting a simplified two-view echocardiogram obtained by trained echocardiographers? Crit Ultrasound J. 2015 Apr 18;7:5. doi: 10.1186/s13089-015-0022-8. PMID: 25932319; PMCID: PMC4409610. Furukawa A, Abe Y, Morizane A, Miyaji T, Hosogi S, Ito H. Simple echocardiographic scoring in screening aortic stenosis with focused cardiac ultrasonography in the emergency department. J Cardiol. 2021 Jun;77(6):613-619. doi: 10.1016/j.jjcc.2020.12.006. Epub 2020 Dec 29. PMID: 33386216. Lin J, Drapkin J, Likourezos A, Giakoumatos E, Schachter M, Sarkis JP, Moskovits M, Haines L, Dickman E. Emergency physician bedside echocardiographic identification of left ventricular diastolic dysfunction. American Journal of Emergency medicine  Ehrman RR, Russell FM, Ansari AH, Margeta B, Clary JM, Christian E, Cosby KS, Bailitz J. Can emergency physicians diagnose and correctly classify diastolic dysfunction using bedside echocardiography? Am J Emerg Med. 2015 Sep;33(9):1178-83. doi: 10.1016/j.ajem.2015.05.013. Epub 2015 May 21. PMID: 26058890.2021;44:20-25 Del Rios M, Colla J, Kotini-Shah P, Briller J, Gerber B, Prendergast H. Emergency physician use of tissue Doppler bedside echocardiography in detecting diastolic dysfunction: an exploratory study. Crit Ultrasound J. 2018 Jan 25;10(1):4. doi: 10.1186/s13089-018-0084-5. PMID: 29372430; PMCID: PMC5785451. Thiele H, Zeymer U, Neumann FJ, Ferenc M, Olbrich HG, Hausleiter J, de Waha A, Richardt G, Hennersdorf M, Empen K, Fuernau G, Desch S, Eitel I, Hambrecht R, Lauer B, Böhm M, Ebelt H, Schneider S, Werdan K, Schuler G; Intraaortic Balloon Pump in cardiogenic shock II (IABP-SHOCK II) trial investigators. Intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock (IABP-SHOCK II): final 12 month results of a randomised, open-label trial. Lancet. 2013 Nov 16;382(9905):1638-45. doi: 10.1016/S0140-6736(13)61783-3. Epub 2013 Sep 3. PMID: 24011548. Aksoy O, Yousefzai R, Singh D, Agarwal S, O'Brien B, Griffin BP, Kapadia SR, Tuzcu ME, Penn MS, Nissen SE, Menon V. Cardiogenic shock in the setting of severe aortic stenosis: role of intra-aortic balloon pump support. Heart. 2011 May;97(10):838-43. doi: 10.1136/hrt.2010.206367. Epub 2010 Oct 20. PMID: 20962337. Karatolios K, Chatzis G, Luesebrink U, Markus B, Ahrens H, Tousoulis D, Schieffer B. Impella support following emergency percutaneous balloon aortic valvuloplasty in patients with severe aortic valve stenosis and cardiogenic shock. Hellenic J Cardiol. 2019 May-Jun;60(3):178-181. doi: 10.1016/j.hjc.2018.02.008. Epub 2018 Mar 21. PMID: 29571667. Gottlieb M, Long B, Koyfman A. Evaluation and Management of Aortic Stenosis for the Emergency Clinician: An Evidence-Based Review of the Literature. J Emerg Med. 2018 Jul;55(1):34-41. doi: 10.1016/j.jemermed.2018.01.026. Epub 2018 Mar 7. PMID: 29525246.  

CardioNerds (Dr. Yoav Karpenshif – Chair of the CardioNerds Critical Care Cardiology Council) join Dr. Munim Khan, Dr. Shravani Gangidi, and Dr. Rachel Goodman from Tufts Medical Center's general cardiology fellowship program for hot pot in China Town in Boston. They discuss a case involving a patient who presented with stress cardiomyopathy leading to cardiogenic shock. Expert commentary is provided by Dr. Michael Faulx from the Cleveland Clinic. Notes were drafted by Dr. Rachel Goodman. A young woman presents with de novo heart-failure cardiogenic shock requiring temporary mechanical circulatory support who is found to have basal variant takotsubo cardiomyopathy.  We review the definition and natural history of takotsubo cardiomyopathy, discuss initial evaluation and echocardiographic findings, and review theories regarding pathophysiology of the clinical syndrome. We also highlight complications of takotsubo cardiomyopathy, with a focus on left ventricular outflow obstruction, cardiogenic shock, and arrythmias. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls Takotsubo cardiomyopathy is defined as a reversible systolic dysfunction with wall motion abnormalities that do not follow a coronary vascular distribution. Takotsubo cardiomyopathy is a diagnosis of exclusion; patients often undergo coronary angiography to rule out epicardial coronary artery disease given an overlap in presentation and symptoms with acute myocardial infarction. There are multiple echocardiographic variants of takotsubo. Apical ballooning is the classic finding, but mid-ventricular, basal, and biventricular variants exist as well. Patients with takotsubo cardiomyopathy generally recover, but there are important complications to be aware of.  These include arrhythmia, left ventricular outflow tract (LVOT) obstruction related to a hyperdynamic base in the context of apical ballooning, and cardiogenic shock. Patients with Impella devices are at risk of clot formation and stroke. Assessing the motor current can be a clue to what is happening at the level of the motor or screw. Notes What is Takotsubo Syndrome (TTS)? TTS is a syndrome characterized by acute heart failure without epicardial CAD with regional wall motion abnormalities seen on echocardiography that do not correspond to a coronary artery territory (see below).1 TTS classically develops following an acute stressor—this can be an emotional or physical stressor.1 An important feature of TTS is that the systolic dysfunction is reversible.  The time frame of reversibility is variable, though generally hours to weeks.2 Epidemiologically, TTS has a predilection for post-menopausal women, however anyone can develop this syndrome.1 TTS is a diagnosis of exclusion. Coronary artery disease (acute coronary syndrome, spontaneous coronary artery dissection, coronary embolus, etc) should be excluded when considering TTS. Myocarditis is on the differential diagnosis. What are the echocardiographic findings of takotsubo cardiomyopathy? The classic echocardiographic findings of TTS is “apical ballooning,” which is a way of descripting basal hyperkinesis with mid- and apical hypokinesis, akinesis, or dyskinesis.3 There are multiple variants of TTS. The four most common are listed below:3(1) Apical ballooning (classic TTS)(2) Mid-ventricular variant(3) Basal variant (4) Focal variant Less common variants include the biventricular variant and the isolated right ventricular  variant.3 Do patients with TTS generally have EKG changes or biomarker elevation? Patients often have elevated troponin, though the severity wall motion abnormalities seen on TTE i...

The Australian ERAS+ Conference and 2024 World Congress of Prehabilitation and Perioperative Medicine is an essential event for practitioners around the world. TopMedTalk were there and we will be bringing you a series of interviews with some of the key players and speakers. This piece is presented by Kate Leslie and Mike Grocott with their guest, David Watters, Alfred Deakin Professor of Surgery at Deakin University in Geelong, Victoria, Australia, based at the University Hospital Geelong, he is also Director of Surgery at Safer Care Victoria. -- TopMedTalk has ramped up its release schedule recently in response to growing demand for our recent conference coverage. Expect to see releases more frequently over the next few months. Ensure you are subscribed to us, so you don't miss out, and while you're here why not check out some of our new recent releases: ASA Presidents pass the baton | #ANES24 https://topmedtalk.libsyn.com/asa-presidents-pass-the-baton-anes24 The evolution of the Impella device in anesthesia, critical care, and perioperative medicine | #ANES24 https://topmedtalk.libsyn.com/the-evolution-of-the-impella-device-in-anesthesia-critical-care-and-perioperative-medicine-anes24    

The American Society of Anesthesiologists (ASA)'s annual general meeting; Anesthesiology 2024. Exclusive cutting edge conversations recorded at the conference with some of the key speakers, guests and delegates. The discussion highlights the growing use of the Impella device in anesthesia and critical care, particularly for high-risk patients with severe heart failure or cardiogenic shock. Presented by Desiree Chappell, Monty Mythen and Mike Grocott with their guest Asad Usman, Anesthesiologist, critical care specialist and physician with Penn Medicine, Pennsylvania.

On this week's listener series episode, Jess shares the birth story of her daughter, the second of her four children. Jess' birth was mostly uncomplicated until immediately following her delivery via csection when breathing became difficult and her heart rate skyrocketed. Jess' heart was failing and her doctors scrambled to keep her alive. Through the use of ECMO and Impella, along with many other interventions and procedures Jess' life was saved. She shares more about what lead to her heart failure and subsequent cardiac arrest along with her two subsequent pregnancies/births in this episode.  On this episode, you will hear:- Retrograde amnesia- High blood pressure in pregnancy- Cardiac arrest and the use of Impella and ECMO- Discovering a tumor and surgery following- Subsequent c-sections and healing processIf you have a birth trauma story you would like to share with us, click this link and fill out the form. For more birth trauma content and a community full of love and support, head to my Instagram at @thebirthtrauma_mama.Learn more about the support and services I offer through The Birth Trauma Mama Therapy & Support Services.

Are there different training protocols for maintaining expertise in Impella patient management when cases are infrequent? In this episode, Shane Turner is joined by Dustin McKeel, a seasoned Flight Paramedic and Clinical Base Educator from Memphis, to explore how the city's limited critical care options have spurred innovative training solutions.Learn how hands-on cadaver labs, real case studies, and rigorous simulations are equipping transport crews with the confidence and skills needed to handle complex patient scenarios effectively. Don't miss this insightful discussion on enhancing clinical capabilities and decision-making skills through advanced training methods.In this episode:Shane Turner, RN, CFRN, NRP, FP-C, CMTE, Chattanooga, TNDustin McKeel, FP-C, Flight Paramedic, Clinical Base Educator, Memphis, TN

This piece looks at the DanGer Shock Trial which examines the efficacy of the Impella device in reducing mortality in patients with acute myocardial infarction and cardiogenic shock. We explain how the device works, its implantation process, and the significant findings from the trial, including a notable reduction in six-month mortality with a number needed to treat (NNT) of eight. Despite higher rates of bleeding and renal filtration therapy in the Impella group, the trial provides strong evidence supporting its use in high-volume centers with trained personnel, emphasizing the importance of careful patient selection and timely intervention. Presented by Andy Cumpstey and Joff Lacey with their guest Vasileios Panneudales, an interventional cardiologist at Brompton and Harefield Hospitals.

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Show notes at pharmacyjoe.com/episode931. In this episode, I'll discuss an alternative to a dextrose-based purge solution for patients with an Impella ventricular assist device that also need a PET scan. The post 931: Non-dextrose purge solution for patients with an Impella that require a PET scan appeared first on Pharmacy Joe.

Keeping Impella access sites exposed during movement and transport can make a critical difference in patient care, especially during short ground transports. In this episode, former flight nurse D.D. Finder sits down with trainer Jena Billig to recount a challenging case involving a heart failure patient on an Impella device for ECMO treatment. In this episode:Jena Billig, BSN, RN, CCRN, CFRN, Idaho Springs, ColoradoD.D. Finder, RN, BSN, CCRN, CFRN, Colorado

Welcome to Abiomed's Quarterly Update, where education is at the forefront. In this episode, host Shane Turner is joined by Jena Billig, primary trainer for the West region, to dive into the intricacies of the Impella pump's heparin-free purge system.Jena provides a comprehensive understanding while addressing misconceptions. She explains the importance of using a dextrose and water-based purge solution with heparin or sodium bicarb additive to prevent blood proteins from accumulating in the pump motor housing. Plus, Shane and Jena explore new features of the Impella Five, gen two catheter, designed to enhance safety for transport providers, including the intuitive catalog system and three-point fixation method.Whether you're a seasoned provider or new to the field, this episode offers valuable insights to improve patient care and transport practices. Tune in now to stay informed and elevate your knowledge of the Impella device and purge system!In this episode:Shane Turner, RN, CFRN, NRP, FP-C, CMTE, Chattanooga, TNJena Billig, BSN, RN, CCRN, CFRN, Idaho Springs, Colorado

ESC TV Today brings you concise analysis from the world's leading experts, so you can stay on top of what's happening in your field quickly. This episode covers: Cardiology This Week: A concise summary of recent studies Long-term beta blockers after myocardial infarction Pros and Cons of the microaxial pump in cardiogenic shock Snapshots Host: Perry Elliott Guests: Stephan Achenbach, Carlos Aguiar, Michael Boehm, Lene Holmvang Want to watch that episode? Go to: https://esc365.escardio.org/event/1151   Disclaimer This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. Declarations of interests Stephan Achenbach, Michael Boehm, Lene Holmvang and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, Lilly, Novartis, Pfizer, Sanofi, Servier, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Novo Nordisk, Sanofi. Terumo, Medtronic. Emma Svennberg has declared to have potential conflicts of interest to report: institutional research grants from Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Boehringer-Ingelheim, Johnson & Johnson, Merck Sharp & Dohme.

An Impella update, another TAVI vs SAVR trial, two studies on angina and PCI, another null substudy from REVIVED-BCIS, and semaglutide are the topics John Mandrola, MD, covers in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Impella Update CHRIP BCIS 3 https://classic.clinicaltrials.gov/ct2/show/NCT05003817 Danger-Shock Podcast https://www.medscape.com/viewarticle/1000675 II. TAVI vs SAVR Notion 2 Trial EHJ https://doi.org/10.1093/eurheartj/ehae331 DEDICATE-DZHK6 III. Angina and PCI Orbita 2 Sub-analysis Orbita Star https://www.jacc.org/doi/10.1016/j.jacc.2024.04.001 IV. Complete Revascularization Main REVIVED trial https://www.nejm.org/doi/full/10.1056/NEJMoa2206606 JACC Substudy https://www.jacc.org/doi/10.1016/j.jacc.2024.04.043 V. Semaglutide Semaglutide CV Benefits Irrespective of Weight Loss: 4-Year SELECT Data https://www.medscape.com/viewarticle/semaglutide-cv-benefits-irrespective-weight-loss-4-year-2024a100095z Nature Med substudy https://www.nature.com/articles/s41591-024-02996-7 SELECT Main paper https://www.nejm.org/doi/full/10.1056/NEJMoa2307563 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

In this in-depth episode, cardiac nursing expert Sean from the Nurse Dose Podcast vividly illustrates how acute coronary syndromes, valve dysfunction, arrhythmias, and mechanical complications can all culminate in cardiogenic shock. You'll learn to spot the ominous signs like falling cardiac output, rising filling pressures, and poor end-organ perfusion. But most importantly, Sean equips you with the critical interventions - from revascularization to advanced circulatory support devices like balloon pumps and Impella pumps. Whether you're an ICU nurse or just want to solidify your knowledge of this high-stakes condition, this masterclass on cardiogenic shock is a must-listen. This episode is part of Nurses' PodCrawl 2024. Check out other episodes from these excellent nurse podcasters: Obstructive Shock: Critical Care Scenarios and Rapid Response RN Distributive shock: Straight A Nursing and How Not to Kill Your Patient Hypovolemic shock: The Q Word Podcast and Up My Nursing Game From this episode: Listen to the Nurse Dose Podcast Check out Nurse Dose on IG! @NurseDosePodcast Check out Nicole Kupchik's exam reviews and practice questions at nicolekupchikconsulting.com. Use the promo code UPMYGAME20 to get 20% off all products. Do you need help with your resume, interviewing, or need career coaching? Check out Sarah at New Thing Nurse: Get 15% off of her resume and cover letter templates using the promo code UPMYGAME Nursing students and new grad career services  Experienced RN career services NP career services

Beyond logistics, safe transport requires effective communication, thorough planning and a commitment to continual learning. Today, Shane Turner is joined by Billy Thompson, a seasoned flight nurse with extensive experience in managing Impella patients. Plus, Shane and Billy explore key considerations such as assessing patient stability and properly securing the Impella console. Whether you're a seasoned transport professional or new to the field, this episode provides invaluable insights to ensure the safe and effective transport of these complex patients.

ACC Recap #1: DanGer Shock (plus a sobering JAMA research letter on Impella use), REDUCE-AMI, PREVENT, and EMPACT-MI are the topics John Mandrola, MD, covers in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. DanGer-Shock Trial Impella CP Improves Survival in STEMI, Cardiogenic Shock https://www.medscape.com/viewarticle/impella-cp-improves-survival-stemi-cardiogenic-shock-2024a10006kz Impella Saves Lives in Cardiogenic Shock, but Patient Selection Key https://www.medscape.com/viewarticle/1000659 Published DanGer Shock Study  https://www.nejm.org/doi/full/10.1056/NEJMoa2312572 JAMA Research letter https://jamanetwork.com/journals/jama/article-abstract/2817457 II. REDUCE-AMI Trial New Data Question Beta-Blockers Post-MI With Preserved EF https://www.medscape.com/viewarticle/new-data-question-beta-blockers-post-mi-preserved-ef-2024a10006y8 Beta-Blockers Post-MI Past Their Expiration Date: REDUCE-AMI https://www.medscape.com/viewarticle/1000663 REDUCE-AMI paper https://www.nejm.org/doi/full/10.1056/NEJMoa2401479 Meta-analysis: Beta Blockers for MI https://doi.org/10.1016/j.amjmed.2014.05.032 III. PREVENT Trial Preventive PCI for Vulnerable Plaques Reduces Cardiac Events https://www.medscape.com/viewarticle/preventive-pci-vulnerable-plaques-reduces-cardiac-events-2024a10006tc Preventive Coronary Stents: Not There Yet https://www.medscape.com/viewarticle/preventive-coronary-stents-not-there-yet-2024a10006yr PREVENT https://doi.org/10.1016/S0140-6736(24)00413-6 IV. EMPACT MI trial of Empagliflozin in the Post-MI setting Empagliflozin Fails to Reduce Events After Acute MI https://www.medscape.com/viewarticle/empagliflozin-fails-reduce-events-after-acute-mi-2024a10006kn EMPACT-MI: Another SGLT2 Inhibitor Miss in Post-MI Care  https://www.medscape.com/viewarticle/1000684 EMPACT MI https://www.nejm.org/doi/10.1056/NEJMoa2314051 DAPA MI https://evidence.nejm.org/doi/full/10.1056/EVIDoa2300286 PARADISE MI https://www.nejm.org/doi/full/10.1056/NEJMoa2104508 Kaul thread https://x.com/kaulcsmc/status/1776611935842165029 Kaul paper https://www.ahajournals.org/doi/full/10.1161/circulationaha.116.022537 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Memorial Hermann Life Flight created an innovative approach to improving patient care and transport efficiency for critically ill patients requiring Impella support. Go behind the scenes to discover how their program's transition to independently transporting patients with Impella devices has led to reduced transport times and enhanced patient outcomes. Plus, gain valuable insights and recommendations for implementing similar models in your transport program.In this episode:Diana Draehn, Abiomed Critical Care Team Trainer, Dallas, TXRudy Cabrera, Director and Chief Flight Nurse, Memorial Hermann Life FlightTony Herrera, Clinical Educator, Memorial Hermann Life FlightNPS-4298

As members of Abiomed's Critical Care Transport Team, we know that every transport is a lifeline, and every moment counts in our mission to recover hearts and save lives. Inside Impella: Transport Talks is a podcast where we equip you with knowledge and confidence as you transport Impella patients. Subscribe now for monthly episodes offering best practices, valuable lessons, and camaraderie. Let us be your companion as you focus on what truly matters: patient recovery and saving lives beyond the hospital walls.

Host Sarah Lorenzini and Christian Guzman APRN are back to conclude this three-part heart failure series by examining the use of mechanical circulatory support for cardiogenic shock. This episode expands on the topics covered in previous parts, focusing on the application of mechanical circulatory support methods like the intra-aortic balloon pump, Impella, CentriMag, LVADs, and ECMO.Christian and Sarah review the risks and benefits of each device, when to use them, and the key factors that impact these decisions. They also address the ethical challenges of ECMO, including the clinical judgment involved when determining who's a good candidate and when to escalate care.By the end of this episode, you'll understand how these devices function, their critical role in managing cardiogenic shock in heart failure patients, and the value nurses bring to a multidisciplinary team.Tune in for a knowledge-packed finale of this comprehensive heart failure series!Topics discussed in this episode:The role of mechanical circulatory support devicesBenefits and risks of the intra-aortic balloon pump and Impella deviceHow to properly use Impella devicesCentriMag and Left Ventricular Assist Devices (LVADs)The evolution of permanent LVADsExtracorporeal Membrane Oxygenation (ECMO) for cardiac supportChallenges and ethical considerations of ECMOThe importance of nursing knowledge and confidenceConnect with Christian Guzman APRN on Instagram:https://www.instagram.com/thenerdynursepractitioner/Watch this episode on The Rapid Response RN YouTube Channel! https://www.youtube.com/@therapidresponsern/videosMentioned in this episode:Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the SickClick here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/coming-soon-rapid-response-academy Rapid Response and Rescue Intro CourseCONNECT

Show notes at pharmacyjoe.com/episode874. In this episode, I’ll discuss what Impella purge solution can be used if the patient has a contraindication to heparin. The post 874: How Well Does a Bicarb-Based Impella Purge Solution Work for Patients With Contraindications to Heparin? appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode874. In this episode, I’ll discuss what Impella purge solution can be used if the patient has a contraindication to heparin. The post 874: How Well Does a Bicarb-Based Impella Purge Solution Work for Patients With Contraindications to Heparin? appeared first on Pharmacy Joe.

Anika Therapeutics received the final FDA 510(k) clearance for its Integrity implant system for improving outcomes in rotator cuff repair procedures through biologic healing. The hyaluronic acid-based patch augments an injured tendon, promoting rotator cuff healing. Fast Five hosts Sean Whooley and Danielle Kirsh delve into how the device works and what the regulatory nod means for Anika. Ventricular assist devices save lives and another one may soon be entering the fold. MagAssist won FDA breakthrough device designation for its NyokAssist VAD, which provides mechanical circulatory support for high-risk percutaneous interventions. Find out what led the agency to grant this designation. Axonics will soon have a new chief financial officer after longtime executive Dan Dearen notified the company of his intent to retire. The company already picked a replacement, promoting from within to fill the role. Learn more about Axonics' selection and what the new executive brings to the company in terms of experience and know-how. In another executive change, Tandem Diabetes Care announced that its chief commercial officer plans to resign from the role. Brian B. Hansen had been the company's CCO since 2016. Whooley and Kirsh take a look at Hansen's background and the terms of a separation agreement struck between Hansen and the automated insulin delivery technology developer. For the third time in as many months, Abiomed issued a correction for its Impella heart pumps. The FDA Class I recall pertains to the instructions for use for the system. The hosts break down the numbers behind this recall and what kind of mitigations Abiomed is implementing to remedy the issue. Check out the show notes for links to the stories we discussed today at MassDevice.com/podcast.

CardioNerds co-founder Dr. Amit Goyal and episode leads Dr. Jaya Kanduri (FIT Ambassador from Cornell University) and Dr. Jenna Skowronski (FIT Ambassador from UPMC) discuss Complications of acute myocardial infarction with expert faculty Dr. Jeffrey Geske. They discuss various complications of acute MI such as cardiogenic shock, bradyarrythmias, left ventricular outflow tract obstruction, ruptures (papillary muscle rupture, VSD, free wall rupture), and more. Show notes were drafted by Dr. Jaya Kanduri. Audio editing by CardioNerds Academy Intern, student doctor Tina Reddy. The CardioNerds Beyond the Boards Series was inspired by the Mayo Clinic Cardiovascular Board Review Course and designed in collaboration with the course directors Dr. Amy Pollak, Dr. Jeffrey Geske, and Dr. Michael Cullen. CardioNerds Beyond the Boards SeriesCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls and Quotes - Complications of Acute Myocardial Infarction Sinus tachycardia is a “harbinger of doom”! The triad for RV infarction includes hypotension, elevated JVP, and clear lungs. These patients are preload dependent and may need fluid resuscitation despite having an elevated JVP. Bradyarrythmias in inferior MIs are frequently vagally mediated. The focus should be on medical management before committing to a temporary transvenous pacemaker, such as reperfusion, maintaining RV preload and inotropy, avoiding hypoxia, and considering RV-specific mechanical circulator support (MCS). Worsening hypotension with inotropic agents (e.g., dobutamine, epinephrine, dopamine, norepinephrine) after a large anterior-apical MI should raise suspicion for dynamic left ventricular outflow tract obstruction due to compensatory hyperdynamic basal segments. The myocardium after a late presentation MI is as “mushy as mashed potatoes”! Need to look out for papillary muscle rupture, VSD, and free wall rupture as potential complications. Papillary muscle rupture can occur with non-transmural infarcts, and often presents with flash pulmonary edema. VSDs will have a harsh systolic murmur and are less likely to present with pulmonary congestion. Free wall rupture can present as a PEA arrest. All of these complications require urgent confirmation on imaging and early involvement of surgical teams. Notes - Complications of Acute Myocardial Infarction How should we approach cardiogenic shock (CS) in acute myocardial infarction (AMI)? Only 10% of AMI patients present with CS, but CS accounts for up to 70-80% of mortality associated with AMI, usually due to extensive LV infarction with ensuing pump failure. Physical examSinus tachycardia is considered a “harbinger of doom”, when the body compensates for low cardiac output by ramping up the heart rateThe presence of sinus tachycardia and low pulse and/or blood pressure in a patient with a large anterior MI should raise suspicion for cardiogenic shockBe wary of giving IV beta blockers in this situation as negative inotropes can precipitate cardiogenic shock (Commit Trial) When interpreting a patient's blood pressure in the acute setting, it is helpful to know their baseline blood pressure and if they have a significant history of hypertension. Patients

Abbott has now seen two quarters in a row of double-digit organic sales growth in its underlying business. Now the company is betting on its productive, innovative pipeline to build momentum. Fast Five hosts Sean Whooley and Danielle Kirsh go over the full performance of the company and how each of its segments performed. Johnson & Johnson MedTech posted revenues of $7.9 billion, marking a 12.9% improvement year-over-year. Learn what the growth drivers were for the MedTech segment and what analyst's think about the second-quarter results.  The initiation of Magnus Medical's neurostim trial marks a significant milestone in the field of mental health treatment, offering hope for patients with treatment-resistant depression. Whooley and Kirsh discuss the company's technology and the potential impact it could have on the treatment of treatment-resistant depression.  MediView XR announced this week that it received FDA 510(k) clearance for its XR90 augmented reality-based visualization and navigation platform. Find out the purpose of the AR platform and how it works to address the limitations of traditional medical imaging technologies. Johnson & Johnson's Abiomed unit issued another recall for some of its Impella heart pumps. The recall is for TAVR-related devices. Whooley explains the reason for the recall, the risks involved and provides comments from Abiomed on the situation.  Check out the show notes for links to the stories we discussed today at MassDevice.com/podcast.

Hey everyone! Just a quick update for y'all! My first book has been published on Amazon! "From Novice to Nurse: Empowering Reflections" My new 11-page Hemodynamic Crash Course is now available HERE along with all my other cheat sheets for the Balloon Pump, Impella, and more! We have got some great episodes in the works so get subscribed so you are notified when they are released. Talk to y'all soon!

Starting HF meds during hospitalization for HF, Impella, testosterone, and colchicine are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Starting HF Meds During Hospitalization for HF Starting Indicated Heart Failure Meds In-Hospital: Progress, Opportunities https://www.medscape.com/viewarticle/993539 - Opportunities and Achievement of Medication Initiation Among Inpatients With Heart Failure With Reduced Ejection Fraction https://www.jacc.org/doi/full/10.1016/j.jchf.2023.04.015 II. Impella - Comparative Effectiveness of Percutaneous Microaxial Left Ventricular Assist Device vs Intra-Aortic Balloon Pump or No Mechanical Circulatory Support in Patients With Cardiogenic Shock https://jamanetwork.com/journals/jamacardiology/fullarticle/2806562 - Evidence Generation for Novel Cardiovascular Devices—Putting the Horse Back in Front of the Cart https://jamanetwork.com/journals/jamacardiology/fullarticle/2806565 III. Testosterone Big Trial Reassures on Heart Safety of Testosterone in Men https://www.medscape.com/viewarticle/993322 - Cardiovascular Safety of Testosterone-Replacement Therapy https://www.nejm.org/doi/full/10.1056/NEJMoa2215025 IV. Colchicine for CV Disease Low-Dose Colchicine Approved for CVD: Now What? https://www.medscape.com/viewarticle/993578 - Efficacy and Safety of Low-Dose Colchicine after Myocardial Infarction https://www.nejm.org/doi/full/10.1056/nejmoa1912388 - Colchicine in Patients with Chronic Coronary Disease https://www.nejm.org/doi/full/10.1056/nejmoa2021372 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Impella, digital health, low-value processes, are tricuspid valve interventions with pacing leads are the topics Dr. John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Impella Class I Recall FDA Class I Recall for Some Abiomed Impella Heart Pumps https://www.medscape.com/viewarticle/992845 - A Prospective, Randomized Clinical Trial of Hemodynamic Support With Impella 2.5 Versus Intra-Aortic Balloon Pump in Patients Undergoing High-Risk Percutaneous Coronary Intervention https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.112.098194 - Percutaneous Mechanical Circulatory Support Versus Intra-Aortic Balloon Pump in Cardiogenic Shock After Acute Myocardial Infarction https://doi.org/10.1016/j.jacc.2016.10.022 https://www.sciencedirect.com/science/article/pii/S0735109716367675?via%3Dihub - The Evolving Landscape of Impella Use in the United States Among Patients Undergoing Percutaneous Coronary Intervention With Mechanical Circulatory Support https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.119.044007 - Association of Use of an Intravascular Microaxial Left Ventricular Assist Device vs Intra-aortic Balloon Pump With In-Hospital Mortality and Major Bleeding Among Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock https://jamanetwork.com/journals/jama/fullarticle/2761003 - Danish Cardiogenic Shock Trial (DanShock) https://clinicaltrials.gov/ct2/show/NCT01633502 II. Wearable Devices - Use of Wearable Devices in Individuals With or at Risk for Cardiovascular Disease in the US, 2019 to 2020 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2805753 doi:10.1001/jamanetworkopen.2023.16634 - Implantable loop recorder detection of atrial fibrillation to prevent stroke (The LOOP Study): a randomised controlled trial https://doi.org/10.1016/S0140-6736(21)01698-6 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01698-6/fulltext - Prevalence and Prognostic Significance of Bradyarrhythmias in Patients Screened for Atrial Fibrillation vs Usual Care https://jamanetwork.com/journals/jamacardiology/fullarticle/2801362 III. The Cost of Quality Measures - The Volume and Cost of Quality Metric Reporting https://jamanetwork.com/journals/jama/fullarticle/2805705 - Goodhart's law https://en.wikipedia.org/wiki/Goodhart%27s_law IV. Tricuspid Valve Interventions and Pacing Leads Leadless Dual-Chamber Pacemaker Clears Early Safety, Performance Hurdles https://www.medscape.com/viewarticle/992464 - Transcatheter Tricuspid Valve Replacement With the EVOQUE System: 1-Year Outcomes of a Multicenter, First-in-Human Experience https://www.jacc.org/doi/10.1016/j.jcin.2022.01.280 - Effects of Implantable Cardioverter-Defibrillator Leads on the Tricuspid Valve and Right Ventricle: A Randomized Comparison of Transvenous versus Subcutaneous Leads https://eppro01.ativ.me/src/EventPilot/php/express/web/planner.php?id=HRS23&utm_source=heartrhythm&utm_medium=nav-button&utm_campaign=hr23-webtracking - Management and Outcomes of Transvenous Pacing Leads in Patients Undergoing Transcatheter Tricuspid Valve Replacement https://www.jacc.org/doi/10.1016/j.jcin.2020.04.054 - TRILUMINATE trial -- Transcatheter Repair for Patients with Tricuspid Regurgitation https://www.nejm.org/doi/full/10.1056/NEJMoa2300525 https://www.nejm.org/doi/full/10.1056/NEJMoa2300525 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Sparrow BioAcoustics' FDA clearance for their smartphone stethoscope marks a significant advancement in remote patient monitoring and telehealth. This innovative technology allows healthcare professionals to capture and analyze heart and lung sounds using a smartphone, enabling more accessible and convenient monitoring of patients' respiratory health. Fast Five hosts Sean Whooley and Danielle Kirsh have all the details. The FDA clearance of GE Healthcare's Sonic DL AI technology for expediting MRI scans is another significant breakthrough in medical imaging. This platform could enable new imaging paradigms, including high-quality cardiac MRI in a single heartbeat. Whooley explains how the technology works and what this could mean for cardiac imaging and healthcare. Masimo's FDA clearance of its vital sign monitor highlights the importance of telehealth in today's healthcare settings. This wearable device provides continuous monitoring of key vital signs, such as heart rate, oxygen saturation, and respiratory rate, enabling healthcare professionals to track patients' health parameters outside of traditional clinical settings. Kirsh and Whooley discuss the technology and how it works.  Novo Nordisk's potential acquisition of a majority stake in BioCorp demonstrates the growing interest of pharmaceutical companies in digital health solutions. It follows Bayer's announcement last week that it was making a move to digital health. Whooley explains the financial details of the deal and how optimistic executives are at both companies. Abiomed's recall of certain Impella 5.5 with SmartAssist devices is an important step in ensuring patient safety and maintaining quality standards. Product recalls are a vital aspect of post-market surveillance and risk management, aiming to address any potential issues that may arise with medical devices. The Fast Five hosts share the details of the recall, including how many devices are affected and if there have been any reported complaints related to the device. Check out the show notes at MassDevice.com/podcast.

An HRS meeting recap, Impella failure, sacubitril/valsartan, the purpose of trials, and a major breakthrough in evidence generation are the topics discussed by John Mandrola, MD in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. HRS Meeting Recap II. Impella in VT ablation - First-in-human Experience with Impella 5.0/5.5 for High-Risk Patients with Advanced Heart Failure Undergoing VT Ablationhttps://www.jacc.org/doi/10.1016/j.jacc.2023.05.012 III. Sacubitril/Valsartan ARNI Bests ARB to Reduce NT-proBNP in Stabilized Preserved-EF HF https://www.medscape.com/viewarticle/992461 - Angiotensin-Neprilysin Inhibition in Patients With Mildly Reduced or Preserved Ejection Fraction and Worsening Heart Failure https://www.jacc.org/doi/10.1016/j.jacc.2023.04.019 - Angiotensin–Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction https://www.nejm.org/doi/full/10.1056/nejmoa1908655 - Sacubitril/valsartan in heart failure with mildly reduced or preserved ejection fraction: a pre-specified participant-level pooled analysis of PARAGLIDE-HF and PARAGON-HF https://doi.org/10.1093/eurheartj/ehad344 - Bogdan Tweet https://twitter.com/bogdienache/status/1660356776204595201?s=20 IV. Big Change in Reporting of Medical Evidence – Elan Trial - Early versus Later Anticoagulation for Stroke with Atrial Fibrillationhttps://www.nejm.org/doi/full/10.1056/NEJMoa2303048 - Early versus Late initiation of direct oral Anticoagulants in post-ischaemic stroke patients with atrial fibrillatioN (ELAN): Protocol for an international, multicentre, randomised-controlled, two-arm, open, assessor-blinded trial https://doi.org/10.1177/23969873221106043 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact: news@medscape.net