scholarly journals The Role of Hemodynamic Support in High-risk Percutaneous Coronary Intervention

2020 ◽  
Vol 14 ◽  
Author(s):  
Charles Simonton ◽  
Craig Thompson ◽  
Jason R Wollmuth ◽  
D Lynn Morris ◽  
Thom G Dahle
Keyword(s):  
Percutaneous Coronary Intervention ◽  
High Risk ◽  
Heart Function ◽  
Coronary Intervention ◽  
Special Focus ◽  
Centrifugal Pumps ◽  
Hemodynamic Support ◽  
Improved Outcomes ◽  
Percutaneous Coronary ◽  
Support Devices

Patients with advanced age, complex coronary anatomy, and multiple comorbidities are often unsuitable for surgical revascularization. In this setting, hemodynamic support devices are used as an adjunct to percutaneous coronary intervention to maintain hemodynamic stability and enable optimal revascularization. This article provides an overview of percutaneous hemodynamic support devices currently used in clinical practice for high-risk percutaneous coronary intervention. These include the intra-aortic balloon pump, centrifugal pumps (TandemHeart, venous arterial extracorporeal membrane oxygenation), and micro-axial Impella pump. The hemodynamic effects, clinical evidence supporting improved outcomes and recovery of heart function, and associated complications with these devices are highlighted, with a special focus on Impella pumps.

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.

Use of the Impella 2.5 in High-Risk Percutaneous Coronary Intervention

2011 ◽  
Vol 31 (1) ◽  
pp. e1-e16 ◽  
Author(s):  
Brenda McCulloch
Keyword(s):  
Percutaneous Coronary Intervention ◽  
High Risk ◽  
Interventional Procedures ◽  
Balloon Catheter ◽  
Limb Ischemia ◽  
Coronary Intervention ◽  
Assist Device ◽  
Hemodynamic Support ◽  
Multidisciplinary Program ◽  
Percutaneous Coronary

The Impella 2.5 is a percutaneously placed partial circulatory assist device that is increasingly being used in high-risk coronary interventional procedures to provide hemodynamic support. The Impella 2.5 is able to unload the left ventricle rapidly and effectively and increase cardiac output more than an intra-aortic balloon catheter can. Potential complications include bleeding, limb ischemia, hemolysis, and infection. One community hospital’s approach to establishing a multidisciplinary program for use of the Impella 2.5 is described.

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