Chuck Simonton, MD, and a panel of physicians—Navin Kapur, MD, Katherine Kunkel, MD, Amir Kaki, MD, and Aditya Bharadwaj, MD—provide perspectives and insights regarding the DanGer Shock Randomized Controlled Trial (RCT) data presented as a late-breaker at the 2024 American College of Cardiology (ACC) Scientific Session. In an interview recorded at ACC, Jacob Møller, MD, the principal investigator of the DanGer Shock trial, discusses trial results. “For the primary endpoint we saw an absolute reduction in all-cause mortality of 13%,” Dr. Møller reports. While mortality was high in both groups, he calls the 13% reduction “quite remarkable” and notes that the curves kept separating. He highlights the ability of Impella to lower both wall stress and filling pressure as a key to heart recovery and discusses the importance of patient selection and the risk/benefit balance in these patients.
Dr. Kaki concludes the panel discussion by talking about complications. He provides insights for reducing stroke, bleeding, limb ischemia, the need for temporary renal replacement therapy and sepsis. He highlights many of the best practices from his institution that are already improving complication rates, including replacing heparin in the purge with bicarbonate, using both ultrasound and fluoroscopy for femoral access, bringing patients back to the cath lab for Impella removal and following protocols and utilizing multidisciplinary shock teams. “Rest assured, we have a lot more work to do. But we're going to together do it and get the complication rates down. And I think we could actually even get the survival even better.”

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