Optimal bridge to transplantation strategy using short‐term mechanical circulatory support devices

2020 ◽  
Vol 34 (10) ◽  
Author(s):  
Teruhiko Imamura
Keyword(s):  
Mechanical Circulatory Support ◽  
Circulatory Support ◽  
Bridge To Transplantation ◽  
Short Term ◽  
Mechanical Circulatory Support Devices ◽  
Support Devices

Portable (short-term) mechanical circulatory support

2018 ◽  
Author(s):  
Susanna Price ◽  
Pascal Vranckx
Keyword(s):  
Mechanical Circulatory Support ◽  
Treatment Options ◽  
Care Physician ◽  
Community Treatment ◽  
Medical Community ◽  
Circulatory Support ◽  
Short Term ◽  
Mechanical Circulatory Support Devices ◽  
Potential Benefits ◽  
Support Devices

Mechanical circulatory support can be used to resuscitate patients, as a stabilizing measure for angiography and prompt revascularization, or to buy time until more definite measures can be taken. In addition, there is experimental evidence that ventricular unloading of the left ventricle can significantly reduce the infarct size. Different systems for mechanical circulatory support are available to the medical community. Treatment options for mechanical circulatory support must be tailored to each patient in order to maximize the potential benefits and minimize the risk of detrimental effects. Intra-aortic balloon pumping is still the most widely used mechanical circulatory support therapy. The relative ease and speed with which this device can be applied to patients with a rapidly deteriorating haemodynamic picture have led to its widespread use as a first-line intervention among critically unstable patients. Where intra-aortic balloon pumping is inadequate, an immediate triage to a more advanced percutaneous (short-term) mechanical circulatory support may be warranted. Despite their extensive use, the utility of mechanical circulatory support devices in acute heart failure syndromes and cardiogenic shock remains uncertain. This chapter concentrates on the application of mechanical circulatory support relevant to the interventional cardiologist and cardiac intensive care physician.

Portable (short-term) mechanical circulatory support

2015 ◽  
Author(s):  
Susanna Price ◽  
Pascal Vranckx
Keyword(s):  
Mechanical Circulatory Support ◽  
Treatment Options ◽  
Care Physician ◽  
Community Treatment ◽  
Medical Community ◽  
Circulatory Support ◽  
Short Term ◽  
Mechanical Circulatory Support Devices ◽  
Potential Benefits ◽  
Support Devices

Mechanical circulatory support can be used to resuscitate patients, as a stabilizing measure for angiography and prompt revascularization, or to buy time until more definite measures can be taken. In addition, there is experimental evidence that ventricular unloading of the left ventricle can significantly reduce the infarct size. Different systems for mechanical circulatory support are available to the medical community. Treatment options for mechanical circulatory support must be tailored to each patient in order to maximize the potential benefits and minimize the risk of detrimental effects. Intra-aortic balloon pumping is still the most widely used mechanical circulatory support therapy. The relative ease and speed with which this device can be applied to patients with a rapidly deteriorating haemodynamic picture have led to its widespread use as a first-line intervention among critically unstable patients. Where intra-aortic balloon pumping is inadequate, an immediate triage to a more advanced percutaneous (short-term) mechanical circulatory support may be warranted. Despite their extensive use, the utility of mechanical circulatory support devices in acute heart failure syndromes and cardiogenic shock remains uncertain. This chapter concentrates on the application of mechanical circulatory support relevant to the interventional cardiologist and cardiac intensive care physician.

Portable (short-term) mechanical circulatory support

2016 ◽  
Author(s):  
Susanna Price ◽  
Pascal Vranckx
Keyword(s):  
Mechanical Circulatory Support ◽  
Treatment Options ◽  
Care Physician ◽  
Community Treatment ◽  
Medical Community ◽  
Circulatory Support ◽  
Short Term ◽  
Mechanical Circulatory Support Devices ◽  
Potential Benefits ◽  
Support Devices

Mechanical circulatory support can be used to resuscitate patients, as a stabilizing measure for angiography and prompt revascularization, or to buy time until more definite measures can be taken. In addition, there is experimental evidence that ventricular unloading of the left ventricle can significantly reduce the infarct size. Different systems for mechanical circulatory support are available to the medical community. Treatment options for mechanical circulatory support must be tailored to each patient in order to maximize the potential benefits and minimize the risk of detrimental effects. Intra-aortic balloon pumping is still the most widely used mechanical circulatory support therapy. The relative ease and speed with which this device can be applied to patients with a rapidly deteriorating haemodynamic picture have led to its widespread use as a first-line intervention among critically unstable patients. Where intra-aortic balloon pumping is inadequate, an immediate triage to a more advanced percutaneous (short-term) mechanical circulatory support may be warranted. Despite their extensive use, the utility of mechanical circulatory support devices in acute heart failure syndromes and cardiogenic shock remains uncertain. This chapter concentrates on the application of mechanical circulatory support relevant to the interventional cardiologist and cardiac intensive care physician.

scholarly journals Percutaneous Axillary Access for Placement of Microaxial Ventricular Support Devices

2020 ◽  
Author(s):  
James M. McCabe ◽  
Amir A. Kaki ◽  
Duane S. Pinto ◽  
Ajay J. Kirtane ◽  
William J. Nicholson ◽  
...  
Keyword(s):  
Mechanical Circulatory Support ◽  
Axillary Artery ◽  
Early Mobilization ◽  
Vascular Complication ◽  
Circulatory Support ◽  
Short Term ◽  
Bleeding Events ◽  
Device Implantation ◽  
Mechanical Circulatory Support Devices ◽  
Support Devices

Background: There has been increasing utilization of short-term mechanical circulatory support devices for a variety of clinical indications. Many patients have suboptimal iliofemoral access options or reasons why early mobilization is desirable. Axillary artery access is an option for these patients, but little is known about the utility of this approach to facilitate short-term use for circulatory support with microaxial pump devices. Methods: The Axillary Access Registry to Monitor Safety (ARMS) was a prospective, observational multicenter registry to study the feasibility and acute safety of mechanical circulatory support via percutaneous upper-extremity access. Results: One hundred and two patients were collected from 10 participating centers. Successful device implantation was 98% (100 of 102). Devices were implanted for a median of 2 days (interquartile range, 0–5 days; range, 0–35 days). Procedural complications included 10 bleeding events and 1 stroke. There were 3 patients with brachial plexus–related symptoms all consisting of C8 tingling and all arising after multiple days of support. Postprocedural access site hematoma or bleeding was noted in 9 patients. Device explantation utilized closure devices alone in 61%, stent grafts in 17%, balloon tamponade facilitated closure in 15%, and planned surgical explant in 5%. Duration of support appeared to be independently associated with a 1.1% increased odds of vascular complication per day ([95% CI, 0.0%–2.3%] P =0.05). Conclusions: Percutaneous axillary access for use with microaxial support pumps appears feasible with acceptable rates of bleeding despite early experience. Larger studies are necessary to confirm the pilot data presented here.

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