Transcript Impella meeting

The AMC MACH program: LVAD in the catheterization laboratory and beyond
STEMI patient in cardiogenic shock or preshock?
Is IABP support enough?
Percutaneous LVAD therapy
Improvement / responder to mechanical support
Destination therapy
Nonresponder
Recovery
Surgical LVAD therapy
Recovery
Bridge to heart transplantation
Figure 1 The AMC MACH program: LVAD in the catheterization laboratory and beyond.
The program was initially started with a focus on the treatment on patients with acute
myocardial infarction presenting with poor hemodynamics. This simple and unspecified
flow chart directs all AMC departments towards upgrading hemodynamic support
according to the circulatory need of the patient. Patients who die on maximum support or
do or not show signs of organ preservation are considered to be ‘nonresponders’. In
contrast, ‘responders’ either recover completely or recover organ and cerebral function
and qualify for further surgical mechanical support if necessary.
Abbreviations: AMC MACH, Academic Medical Center Mechanical support for Acute
Congestive Heart failure in STEMI patients; IABP, intra-aortic balloon counterpulsation;
LVAD, left ventricular assist device; STEMI, ST-segment elevation myocardial infarction.