Ep. 2 Cardiogenic Shock Management: Latest Strategies and Innovations with Dr. Amir Kaki

In 2024, the DanGer Shock trial changed cardiogenic shock guidelines and affected practice patterns internationally. This episode of the BackTable Cardiology Podcast explores tips, tricks, and best practices in utilizing Impella, ECMO, and national initiatives to most effectively treat patients with cardiogenic shock. Host Dr. Sameh Sayfo interviews Dr. Amir Kaki, a noted interventional cardiologist and Director of Mechanical Circulatory Support and Complex PCI at Henry Ford St. John Hospital in Detroit. --- SYNPOSIS The discussion centers on the advances in mechanical circulatory support devices like Impella and ECMO, their history, usage criteria, and impact on patient outcomes. Dr. Kaki details the landmark Detroit Cardiogenic Shock Initiative, the challenges surrounding ECMO use, and the critical implementation of the recent DanGer-SHOCK Trial in clinical practice. After outlining the history of interventions for cardiogenic shock and the significance of recent trials within the field, he emphasizes the necessity for contemporary cardiologists to be skilled in endovascular techniques. --- TIMESTAMPS 00:00 - Introduction02:12 - National Cardiogenic Shock Initiative06:23 - Shock 2 Trial07:48 - ECLS-SHOCK Trial and ECMO15:05 - DanGer Trial22:56 - Parameters for Impella RP vs Impella CP Use in Cardiogenic Shock29:39 - Impella Considerations: Placement, Limb Ischemia, Removal 37:56 - Modern Cardiogenic Shock: Overview and Resources40:16 - Conclusion --- RESOURCES The National Cardiogenic Shock Initiative:https://www.ahajournals.org/doi/10.1161/JAHA.123.031401 DanGer Shock Trial:https://www.acc.org/Latest-in-Cardiology/Clinical-Trials/2024/04/05/04/44/danger-shock Large-Bore Access Site Managementhttps://assets.bmctoday.net/citoday/pdfs/cit0719_SF2_Kaki.pdf Short-Term Mechanical Circulatory Support for Cardiogenic Shockhttps://scai.org/publications/ebooks/short-term-mechanical-circulatory-support-cardiogenic-shock Intraaortic Balloon Support for Myocardial Infarction with Cardiogenic Shockhttps://www.nejm.org/doi/full/10.1056/NEJMoa1208410 Extracorporeal Life Support in Infarct-Related Cardiogenic Shockhttps://www.nejm.org/doi/full/10.1056/NEJMoa2307227 Dr. Amir Kaki, MDhttps://www.heartteam.com/provider/amir-kaki-mdhttps://scai.org/about-us/scai-staff-listing/amir-kaki-md-fscai Dr. Sameh Sayfohttps://www.bswhealth.com/physician/sameh-sayfo