The prognosis for ST-elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS) remains dismal, despite treatment with primary percutaneous coronary intervention (PCI). These patients may benefit from mechanical support. In the current re- port, we describe the history of four STEMI patients with CS, who were bridged to recovery with the Impella percutaneous left ventricular assist device. Patient A was a 46-year-old man who underwent PCI after a period of prolonged resuscitation. After initial stabilization on positive inotropic medication, an Impella 5.0 device was implanted. Patient B was a 57-year-old female who was referred for persistent CS after PCI in a regional hospital, despite positive inotropic medication and intra-aortic balloon pump-treatment. An Impella 5.0 device was implanted upon arrival in hospital. Patient C was a 48-year-old man who underwent Impella 5.0 implantation after PCI and initial Impella 2.5 implantation. Patient D was a 51-year-old man who underwent Impella 2.5 implantation during PCI. Upon presentation, he was not mechanically ventilated. All four patients were eventually discharged home in good clinical condition.
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