Application of Impella Mechanical Circulatory Support Devices in Transcatheter Aortic Valve Replacement and Balloon Aortic Valvuloplasty: A Single-Center Experience

Almajed, Mohamed Ramzi; Mahmood, Shazil; Obri, Mark; Nona, Paul; Gonzalez, Pedro Engel; Chiang, Michael; Wang, Dee Dee; Frisoli, Tiberio; Lee, James; Basir, Mir B.; O’Neill, Brian; O’Neill, William; Villablanca, Pedro

doi:10.1016/j.carrev.2023.03.006

Cited by 4 publications

(2 citation statements)

References 21 publications

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“…In an analysis by Almajed et al, regarding emergent TAVI and BAV in a population consisting of 120 patients (26 TAVI, 94 BAV, 53.9% CS), in specific for etiology analysis, Impella-TAVI in CS patients had a 30-day mortality rate of 34.6%, while Impella-BAV had a 30-day mortality rate of 44.2%. In these cases, Impella was used prior to the procedure in order to achieve hemodynamic stability [ 40 ]. Similar high mortality rates (40%) in patients requiring Impella have been reported by Almalla et al [ 41 ], with low device-associated complications.…”

Section: Urgent Transcatheter Interventions For Aortic Pathologiesmentioning

confidence: 99%

Transcatheter Structural Heart Interventions in the Acute Setting: An Emerging Indication

Pyrpyris,

Dimitriadis,

Theofilis

et al. 2024

JCM

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Structural heart disease is increasingly prevalent in the general population, especially in patients of increased age. Recent advances in transcatheter structural heart interventions have gained a significant following and are now considered a mainstay option for managing stable valvular disease. However, the concept of transcatheter interventions has also been tested in acute settings by several investigators, especially in cases where valvular disease comes as a result of acute ischemia or in the context of acute decompensated heart failure. Tested interventions include both the mitral and aortic valve, mostly evaluating mitral transcatheter edge-to-edge repair and transcatheter aortic valve implantation, respectively. This review is going to focus on the use of acute structural heart interventions in the emergent setting, and it will delineate the available data and provide a meaningful discussion on the optimal patient phenotype and future directions of the field.

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Section: Urgent Transcatheter Interventions For Aortic Pathologiesmentioning

confidence: 99%

Transcatheter Structural Heart Interventions in the Acute Setting: An Emerging Indication

Pyrpyris,

Dimitriadis,

Theofilis

et al. 2024

JCM

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show abstract

“…In the past decade, the management of severe acute heart failure (AHF) has been significantly transformed by the introduction of percutaneously implanted mechanical circulatory support (MCS) devices [ 1 ]. These MCS devices, inserted via a catheter, play a crucial role in temporarily maintaining blood flow during high-risk procedures, such as percutaneous coronary intervention (PCI), transcatheter aortic valve replacement (TAVR), and balloon aortic valvuloplasty (BAV), especially in cases involving cardiogenic shock and severe left ventricle (LV) dysfunction [ 2 , 3 ]. They act as a bridge to recovery (or bridge to decision), facilitating blood flow to vital organs while alleviating strain on the recovering myocardium and allowing the LV to rest.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Mechanical Circulatory Support on Blood Flow in the Ascending Aorta: A Combined Experimental and Computational Study

Hazan Shenberger,

Avrahami

2024

Bioengineering

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Percutaneous mechanical circulatory support (MCS) devices are designed for short-term treatment in cases of acute decompensated heart failure as a bridge to transplant or recovery. Some of the known complications of MCS treatments are related to their hemodynamics in the aorta. The current study investigates the effect of MCS on the aortic flow. The study uses combined experimental and numerical methods to delineate complex flow structures. Particle image velocimetry (PIV) is used to capture the vortical and turbulent flow characteristics in a glass model of the human aorta. Computational fluid dynamics (CFD) analyses are used to complete the 3D flow in the aorta. Three specific MCS configurations are examined: a suction pump with a counterclockwise (CCW) rotating impeller, a suction pump with a clockwise (CW) rotating impeller, and a discharge pump with a straight jet. These models were examined under varying flow rates (1–2.5 L/min). The results show that the pump configuration strongly influences the flow in the thoracic aorta. The rotating impeller of the suction pump induces a dominant swirling flow in the aorta. The swirling flow distributes the incoming jet and reduces the turbulent intensity near the aortic valve and in the aorta. In addition, at high flow rates, the local vortices formed near the pump are washed downstream toward the aortic arch. Specifically, an MCS device with a CCW rotating impeller induces a non-physiological CCW helical flow in the descending aorta (which is opposite to the natural helical flow), while CW swirl combines better with the natural helical flow.

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Short-Term Mechanical Circulatory Support Devices: Uses and Outcomes

Kamga,

Kaira,

Paxton

2024

Curr Emerg Hosp Med Rep

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Application of Impella Mechanical Circulatory Support Devices in Transcatheter Aortic Valve Replacement and Balloon Aortic Valvuloplasty: A Single-Center Experience

Cited by 4 publications

References 21 publications

Transcatheter Structural Heart Interventions in the Acute Setting: An Emerging Indication

Transcatheter Structural Heart Interventions in the Acute Setting: An Emerging Indication

The Effect of Mechanical Circulatory Support on Blood Flow in the Ascending Aorta: A Combined Experimental and Computational Study

Short-Term Mechanical Circulatory Support Devices: Uses and Outcomes

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