Abiomed ELAB Meeting March 3, 2017

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Presentation transcript:

Abiomed ELAB Meeting March 3, 2017 Ruth Fisher, MBA Henry Ford Health System Vice President Heart and Vascular Services Detroit, MI

Detroit Cardiogenic Shock Initiative

Detroit CSI What is Detroit CSI How did we start What are the results Key factors for our success How to start in your market

This is what people think Detroit looks like

This is what Detroit really looks like

What Detroit really looks like

Henry Ford Health System Founded in 1915 by Henry Ford

Detroit CSI 5 competing hospitals systems 8 participating hospital locations

DETROIT CARDIOGENIC SHOCK INITIATIVE DETROIT CSI Detroit Metro – 4.6M Population

What is Detroit CSI Initiative led by cardiovascular leaders at 5 competing hospitals Goal to reduce mortality in Cardiogenic shock patients Developed new Shock treatment protocol 30 patient trial

How did we start? Visionary leader- 30 years in Detroit Created a call to action Partnered with Abiomed to help collect data 30 years in Detroit Taught many of the CV leaders Well known thought leader in acute PCI Dr. William O’Neill, MD

Meeting of the families We can do better Quarterly meetings “Leave your ego at the door” Review current literature/data Case discussion Protocol refinement

Mortality after onset of Shock

Basir, Dixon, O’Neill et al. AJC. 2017 Early support leads to higher survival Basir, Dixon, O’Neill et al. AJC. 2017

Fewer inotropes - higher survival rates Basir, Dixon, O’Neill et al. AJC. 2017

Support first then PCI?

Protocol Hemodynamic support with device BEFORE PCI “Door to Support Time” tracked Measure cardiac output before and after Reduce use of inotropes

Pilot Study July, 2016 – January, 2017 N = 30 Sites: Demographics St Joseph's Pontiac (N=10) Beaumont Royal Oak & Troy (N=9) Henry Ford (N=6) Detroit Medical Center (N=5) Demographics Age 63 +/- 13 years (36-87) 80% Male, 20% Female Diabetics 48%

Pre-Procedural Characteristics Transfer from outside hospital 31% (N=9/29) 4 patient transported with IABP 26% (N=8/30) In Hospital Cardiac Arrest 23% (N=7/30) Required CPR 67% presented to hospital in shock (N=19/28)

Procedural Characteristics 4 patients under active CPR at the time of Impella implantation 75% survival (N=3/4) AMI to Shock Time (N=13) 93 minutes 100% Femoral Access Shock to Device Time (N=23) 64.6 minutes (8-229)

Outcomes Cardiac Power 38% improvement in Cardiac Power Output 0.56 (Pre) (n=15) 0.90 (Post) (n=20) 38% improvement in Cardiac Power Output 38% Out of 30 patients treated with new protocol 24 survived= 80% survival rate

Survival Rates Pre and Post Study

CARDIOGENIC SHOCK A CHANGE IN PARADIGM DOOR TO BALLOON DOOR TO SUPPORT

News Conference Feb 8, 2017

News Conference

News Conference Detroit CSI team

Grateful patient 49 year old Dan Rolston Treated at Beaumont Arrived in shock – flatlined Beaumont cardiologist Ivan Hanson

News Conference "This is exciting because for the first time in two decades, we've found a way to save lives" of cardiogenic shock patients, said Theodore Schreiber, M.D., president of the DMC Heart Hospital

Media Hits Fox 2 TV Top metro Detroit cardiologists team up to test new heart pump Detroit Free Press Newspaper Detroit hospitals see hope for heart attacks with new pump Crain’s Detroit Business Business News Magazine Metro Detroit cardiologists work together to improve heart attack survival rates Detroit News Health systems: New heart attack treatment saving live WWJ Radio Critical Mention clip: WDIV Radio Cardiologists announce results of 'successful effort to save lives' AP/Washington Times Newspaper Cardiologists announce heart attack treatment initiative WILX in Lansing TV

Key Factors to Success Competitors who were willing to collaborate Visionary leader Experienced and highly skilled interventionalists who were comfortable with the Impella device Willing to share their data Abiomed support

How to start a shock program Determine level of experience and comfort with the Impella device in your market Develop a “team” Meeting of the “families” Fellow Acute PCI coordinator CVAD registry / data coordinator Institutional support Hub and spoke model Hospital/ cath lab/ administration Education

Questions