Escalation & De-Escalation With MCS: A Practical Approach – TIO MCS Breakout

Published: 16 January 2024

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    18m 44s
    Part 2 Panel Discussion
    Nicolas M Van Mieghem, Federico Pappalardo, Divaka Perera, Giuseppe Tarantini
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This session provides practical treatment strategies and management of MCS in Cardiogenic Shock: starting with a review of the different phenotype of cardiogenic shock stages and the timing of the treatment of vasopressor, Impella and ECMO as standalone or combined. 

This breakout is supported by Abiomed

Learning Objectives

  • Learn about the different types of cardiogenic shock
  • Discover when to apply vasopressor, Impella and ECMO
  • Explore how to unload ECMO effectively with ECPella to escalate and de-escalate in cardiogenic shock treatment

More from this programme

Part 2


Faculty Biographies

Nicolas M Van Mieghem

Nicolas M Van Mieghem

Medical Director

Prof Nicolas Maria Van Mieghem is an Interventional cardiologist at Thoraxcenter, Erasmus MC, Rotterdam, NL decided to pursue a career that would help others. “I enjoy the feeling of being able to help someone or do something important for them". His father was a general cardiologist and one of his biggest influences early in his career.

Prof Van Mieghem initially intended to train as a cardiac surgeon but decided to specialise in interventional cardiology instead, following advice from a mentor. This decision was cemented when he read the first-in-human case report of transcatheter aortic valve implantation (TAVI) in Circulation by Alain Cribier in 2002. Prof Van Mieghem believes that great cardiologist genuinely cares for their patients. He names Gary Roubin, Dr Manu Malbrain and Professor Patrick Serruys among his mentors. 

His current research focuses on cerebral embolic protection during TAVI and the search for improved…

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Federico Pappalardo

Federico Pappalardo

Prof Federico Pappalardo is Director of CardioThoracic and Vascular Anesthesia and Intensive Care at AO SS Antonio e Biagio e Cesare Arrigo in Alessandria and at AOU Maggiore della Carità in Novara, IT. Prof Pappalardo has been Associate Professor at Vita-Salute San Raffaele University, Milan, (2017-2020), where he worked as Director of the Cardiothoracic Intensive Care Unit (2009-2018) and the Advanced heart failure and Mechanical Circulatory Support Program of San Raffaele Scientific Institute, Milan, IT (2018-2020). 

His major fields of interest are mechanical circulatory support, coagulation, biocompatibility and bioengineering. He has published numerous papers and original research on innovative concepts in the field of short and long term MCS and has developed original patents for medical devices. 

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Divaka Perera

Divaka Perera

Prof Divaka Perera is a Professor of Interventional Cardiology in the School of Cardiovascular Medicine & Sciences and an Honorary Cardiologist at Guy’s and St Thomas’ Hospital. He graduated in medicine from Cambridge University, undertook cardiology specialist training in London and Sussex and received a Clinical Senior Lectureship Award from the Higher Education Funding Council for England in 2008. In 2013, he received the BCS Michael Davies Early Career Award for contribution to cardiovascular science. 

He runs a translational research programme into the mechanisms and consequences of reduced blood supply to the heart muscle in chronic coronary artery disease, acute myocardial infarction and valve disease. He is also involved in designing and performing multicentre clinical trials to evaluate novel treatments for patients with ischaemic heart disease. He is the chief investigator of the NIHR-funded UK multi-centre randomised control trial REVIVED, which seeks to…

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Giuseppe Tarantini

Giuseppe Tarantini

Prof Giuseppe Tarantini is the Head of the Interventional Cardiology Unit within the Department of Cardiac, Thoracic, and Vascular Sciences at the University of Padua Medical School, Padua, IT. He is a globally recognised researcher specialising in ischemic heart disease, structural heart disease, and cardiomyopathies.

Prof Tarantini serves as the primary operator for a diverse array of interventional procedures, encompassing coronary interventions (including atherectomies), peripheral interventions (such as carotid and renal procedures), and structural heart interventions (involving ASDs, PFOs, TAVI, and AVP).

In addition to his clinical work, Prof Tarantini is a distinguished faculty member at various international conferences, including Transcatheter Cardiovascular Therapeutics (TCT), the Congresso della Societa Italiana di Cardiologia Invasiva (SICI-GISE), Euro PCR, and the European Society of Cardiology (ESC). He boasts a publication record of 245 clinical…

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