scholarly journals Remote proctoring for high-risk coronary interventions with mechanical circulatory support during COVID-19 pandemic and beyond

2021 ◽  
Author(s):  
Felix J. Woitek ◽  
Stephan Haussig ◽  
Johannes Mierke ◽  
Axel Linke ◽  
Norman Mangner
Keyword(s):  
High Risk ◽  
Mechanical Circulatory Support ◽  
Case Series ◽  
Digital Technologies ◽  
Interventional Cardiology ◽  
Coronary Intervention ◽  
Circulatory Support ◽  
Audio Quality ◽  
Percutaneous Coronary ◽  
Streaming Technology

AbstractRemote proctoring by advanced digital technologies may help to overcome pandemic, geographic, and resource-related constraints for mentoring and educating interventional cardiology skills. We present a case series of patients undergoing high-risk percutaneous coronary intervention (HR-PCI) with mechanical circulatory support (MCS) guided by remote proctoring to gain insights into a streaming technology platform with regard to video/audio quality, visibility of all structural and imaging details, and delay in transmission. According to our experience, remote proctoring appears to be a reliable, quick, and resource-conserving way to disseminate, educate and improve MCS-supported HR-PCI with implications far beyond the COVID-19 pandemic.

scholarly journals Case series of high-risk percutaneous coronary intervention with rotational atherectomy under short-term mechanical circulatory support with TandemHeart in the setting of acute myocardial infarction

2020 ◽  
Vol 4 (4) ◽  
pp. 1-6
Author(s):  
Leonie Großekettler ◽  
Bastian Schmack ◽  
Hugo A Katus ◽  
Raffi Bekeredjian ◽  
Philip Raake
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
High Risk ◽  
Mechanical Circulatory Support ◽  
Case Series ◽  
Coronary Intervention ◽  
Circulatory Support ◽  
Assist Device ◽  
Ventricular Assist ◽  
Percutaneous Coronary

Abstract Background  TandemHeart is a percutaneous Ventricular Assist Device, most commonly used to provide mechanical circulatory support during high-risk percutaneous coronary intervention and postcardiotomy cardiac failure. However, TandemHeart has not been applied in patients with severe heart failure due to myocardial infarction during high-risk percutaneous coronary intervention with the need for rotational artherectomy (RA) before, so we present a first-in-man case series. Case summary  Three patients with severe HF[Please spell out HF, LA and MI (if necessary).] due to acute myocardial infarction revealed severely calcified lesions of the unprotected left main artery. We successfully used the TandemHeart as percutaneous Ventricular Assist Device during high-risk percutaneous coronary intervention with RA. Discussion  We here report our experience and show that RA under TandemHeart mechanical circulatory support is feasible and safe in case of acute MI.

Percutaneous Mechanical Circulatory Support Devices Use in Cardiogenic Shock and High-Risk Percutaneous Intervention.

2021 ◽  
Vol 8 (08) ◽  
pp. 5578-5583
Author(s):  
Usman Sarwar ◽  
Nikky Bardia ◽  
Amod Amritphale ◽  
Hassan Tahir ◽  
MD Ghulam M.Awan
Keyword(s):  
Percutaneous Coronary Intervention ◽  
High Risk ◽  
Cardiogenic Shock ◽  
Mechanical Circulatory Support ◽  
Coronary Intervention ◽  
Percutaneous Intervention ◽  
Circulatory Support ◽  
Percutaneous Coronary ◽  
Mechanical Circulatory Support Devices ◽  
Support Devices

Statistical data has shown that patients now treated in cardiac catheterization laboratories are older with several comorbidities, including renal failure, diabetes, and heart failure [1]. In past patients who were not suitable candidates for percutaneous coronary intervention due to their numerous comorbidities now seems to be a suitable candidate due to tremendous advancements in the field of interventional cardiology like new stent design and availability of advance mechanical circulatory support devices, i.e., Impella performing PCI on these high-risk patients become a viable option. There are two areas of cardiology in which mechanical circulatory support devices keep evolving: one is high-risk (percutaneous coronary intervention) PCI, and the other is a cardiogenic shock that is refractory to initial pressor support.  In this article, we review evidence base data regarding the use of mechanical circulatory support devices in high-risk percutaneous intervention and cardiogenic shock.

scholarly journals 100.49 Mechanical Circulatory Support Prior to Elective High-Risk Percutaneous Coronary Intervention

2019 ◽  
Vol 12 (4) ◽  
pp. S15
Author(s):  
Sagger Mawri ◽  
Mohammed Dabbagh ◽  
Babar Mir Basir ◽  
Michele Voeltz ◽  
Akshay Khandelwal ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
High Risk ◽  
Mechanical Circulatory Support ◽  
Coronary Intervention ◽  
Circulatory Support ◽  
Percutaneous Coronary

scholarly journals Incidence of Acute Kidney Injury Is Lower in High-Risk Patients Undergoing Percutaneous Coronary Intervention Supported with Impella Compared to ECMO

2021 ◽  
Author(s):  
Julian Schweitzer ◽  
Patrick Horn ◽  
Fabian Voss ◽  
Milena Kivel ◽  
Georg Wolff ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
High Risk ◽  
Mechanical Circulatory Support ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Circulatory Support ◽  
Risk Allocation ◽  
Percutaneous Coronary ◽  
Risk Patients ◽  
Va Ecmo

AbstractAcute kidney injury (AKI) is a common complication post-PCI. Here, in a single-center observational registry, we compared the frequency of AKI in patients at elevated risk for AKI (based on Mehran risk stratification scoring) who underwent VA-ECMO- or Impella-supported high-risk PCI. A total of 28 patients scheduled for elective high-risk PCI with mechanical circulatory support were studied prospectively. All patients were turned down for surgery due to exceedingly high risk. Allocation to VA-ECMO (n=11) or Impella (n=17) was performed according to site-specific restrictions on the daily availability of the VA-ECMO platform as a prospective enrollment and performed prior to initiation of PCI. We analyzed AKI incidence as our primary endpoint, as well as PCI success, duration, and peripheral complications. All patients were successfully revascularized and had MCS weaned at the end of the procedure. Baseline GFR and procedural contrast media were similar. Despite similar risks for AKI as calculated by the Mehran score (35 ± 18.9 vs. 31 ± 16.6 %; p=0.55), patients supported by Impella during PCI demonstrated a reduced incidence of AKI (55 vs. 12 %; p=0.03). MCS-assisted high-risk PCI with VA-ECMO or Impella is feasible. However, Impella is associated with a shorter procedure time and a lower incidence of AKI.

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