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LV Heart Institute in national study

Lehigh Valley Heart Institute is first in the region selected to participate in the National Cardiogenic Shock Initiative to develop best practices and improve the survival of heart attack patients with cardiogenic shock.

Cardiogenic shock is a life-threatening condition that occurs when the heart, for a variety of reasons, suddenly cannot pump enough blood through the body. It often leads to organ failure and death in an estimated 50 percent of patients.

Cardiologists at Henry Ford Medical Center in Detroit developed the National Cardiogenic Shock Initiative, a collaboration among five different Detroit-area hospital systems, with the goal of improving mortality in patients suffering from cardiogenic shock. Data from Detroit shows survival rates have improved to 76 percent through standardization of protocols and use of Impella, often referred to as the world’s smallest heart pump.

This straw-sized heart pump is percutaneously implanted by cardiologists for patients with a failing heart. Impella temporarily enables the heart to rest by improving blood flow and/or performing pumping of the heart.

It is inserted through a catheter in the groin and into the heart to keep blood pumping throughout the body. Doctors can use Impella while they’re treating the cause of a heart attack, either inserting a stent, removing a clot or taking other necessary action while the tiny pump supports circulation.

The pump was approved by the Food and Drug Administration in 2008.

In 2016, it was approved specifically for cardiogenic shock, which led to the development of this national initiative to standardize treatment.

Lehigh Valley Health Network has implemented the Impella device in more than 200 patients.

“At Lehigh Valley Health Network, we were early adopters of the Impella device soon after it was approved by the FDA,” says Ronald Freudenberger, MD, Physician in Chief of Lehigh Valley Heart Institute and one of the area’s only cardiologists with board certification in advanced heart failure. “This experience translated into our hospitals becoming very comfortable with the device in many different patient conditions, including shock and cardiac arrest.”

Impella is available at Lehigh Valley Heart Institute hospitals in Allentown, Bethlehem and Monroe County.

Freudenberger envisions the cardiogenic shock program as a regional service for cardiogenic shock patients, regardless of where they first seek care. The regional heart attack system of care utilizes a comprehensive set of transfer protocols, algorithms, logistics and transport capabilities to transfer patients to Lehigh Valley Heart Institute.

LVHN, which launched the region’s first regional STEMI program for heart attack in 2000, is now one of the largest programs in the country.

“Building on that foundation, the cardiogenic shock program builds on our other programs in cardiac critical care, advanced heart failure and extracorporeal life support, and durable left-ventricular assist devices for end-stage heart failure,” adds Freudenberger.

“Like many communities, there is great variability in the northeastern Pennsylvania community in treating cardiogenic shock,” says James Burke, MD, Associate Chief of Cardiology for LVHI.

“Interventional cardiologists have widely different practice patterns they are very attached to in how they treat patients, relying on comfort and experience.

“By developing evidence-based protocols for treatment of cardiogenic shock and participating in national research and data registries, as a cohesive team of cardiac interventionists, we are improving patient care and can make significant progress in the survival rates for these patients.”

Lehigh Valley Heart Institute is part of Lehigh Valley Health Network. It consists of more than 20 practices throughout the Lehigh Valley and counties in northeastern Pennsylvania, including Lehigh, Northampton, Monroe, Schuylkill, Berks, Luzerne, Pike and Bucks counties.

To learn more about the cardiogenic shock program at Lehigh Valley Health Network, contact Bryan Nelson, MBA, Program Coordinator, for the Regional Cardiogenic Shock and MCS Program, at Bryan_D.Nelson@LVHN.org.

Ronald Freudenberger, MD, Physician in Chief of Lehigh Valley Heart Institute