2015 SCAI/ACC/HFSA/STS clinical expert consensus statement on the use of percutaneous mechanical circulatory support devices in cardiovascular care (Endorsed by the American heart assocation, the cardiological society of India, and sociedad latino Americana de cardiologia intervencion; Affirmation of value by the canadian association of interventional cardiology–association canadienne de cardiologie d'intervention)

Abstract

Although historically the intra-aortic balloon pump has been the only mechanical circulatory support device available to clinicians, a number of new devices have become commercially available and have entered clinical practice. These include axial flow pumps, such as Impella V R ; left atrial to femoral artery bypass pumps, specifically the is approached by other guideline developers and asked to review and consider guidelines for endorsement. Guidelines developed by external organizations will be considered for affirmation of value. The CAIC may not agree with every recommendation in such a document, but overall considers the document to be of educational value to its members. Catheterization and Cardiovascular Interventions 85:E175-E196 (2015)TandemHeart; and new devices for institution of extracorporeal membrane oxygenation. These devices differ significantly in their hemodynamic effects, insertion, monitoring, and clinical applicability. This document reviews the physiologic impact on the circulation of these devices and their use in specific clinical situations. These situations include patients undergoing high-risk percutaneous coronary intervention, those presenting with cardiogenic shock, and acute decompensated heart failure. Specialized uses for rightsided support and in pediatric populations are discussed and the clinical utility of mechanical circulatory support devices is reviewed, as are the American College of Cardiology/American Heart Association clinical practice guidelines.

Extacorporeal life support using a standard oxygenator as an element of cardiopulmonary resuscitation in cardiosurgicalpatients with in-hospital cardiac arrest

“…Если в рекомендациях American Heart Association (AHA) по СЛР и неотложной помощи при сердечно-сосудистых заболеваниях (2010) отношение к целесообразности использования экстракорпоральной поддержки при СЛР (ЭСЛР) оставалось сдержанным, то в обновленных рекомендациях (2015) применение ЭСЛР в отсутствие реакции пациента на СЛР носит рекомендательный характер. Имеются в виду ситуации, когда ЭСЛР можно применить быстро [10][11][12]. Следует отметить, что любой стационар, в котором проводят кардиохирургические вмешательства и/или имеется соответствующее оборудование, такой возможностью располагает [13,14].…”

“…Возраст пациентов составил 60 (28-70) лет, по гендерному признаку преобладали мужчины. По интегральной шкале оценки риска операций на открытом сердце (EuroScore I) пациенты имели средний балл 6 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Инфаркт миокарда имели в анамнезе 12 пациентов.…”

Percutaneous mechanical circulatory support: current concepts and future directions

“…This group published a statement in several major journals earlier this year reviewing the use of percutaneous MCS in cardiovascular care 63. The main conclusions from the expert consensus statement were that MCS: (1) provides superior haemodynamic support compared with pharmacological therapy, (2) should be considered early in patients in CS, (3) that in setting of profound CS, IABP is less likely to be of benefit, (4) higher support devices should be considered early if required and severe biventricular failure may require the use of both right-sided and left-sided devices, and (5) that these devices may be used in patients who have failed to wean off cardiopulmonary bypass, for valvular implants and for patients undergoing an electrophysiological procedure where prolonged periods of hypotension are predicted.…”

The Impella Device: Historical Background, Clinical Applications and Future Directions

“…Awareness of the potential of IABP to reduce the ischemic burden during such high-risk PCI procedures led to its use to increase the efficacy and safety of high-risk PCI (so-called facilitated PCI). [4][5][6] Remarkably, 50 years after the initial report of the device by Kantrowitz et al 1 , the IABP remains the most commonly used method of mechanical circulatory support in the cardiac catheterization laboratory and in the intensive care units. 5 However, in recent years, large scale, randomized clinical trials have failed to demonstrate a clinically useful role for the IABP in the treatment of patients with acute myocardial infarction complicated by cardiogenic shock 7 and in patients undergoing high-risk PCI.…”

“…[4][5][6] Remarkably, 50 years after the initial report of the device by Kantrowitz et al 1 , the IABP remains the most commonly used method of mechanical circulatory support in the cardiac catheterization laboratory and in the intensive care units. 5 However, in recent years, large scale, randomized clinical trials have failed to demonstrate a clinically useful role for the IABP in the treatment of patients with acute myocardial infarction complicated by cardiogenic shock 7 and in patients undergoing high-risk PCI. 8 This has resulted in increased attention to other available forms of mechanical circulatory support systems: the Impella device (Abiomed, Danvers, Massachusetts), the Tandem Heart system (Cardiac Assist, Pittsburgh, PA), and ECMO (percutaneous extracorporeal cardiopulmonary support).…”