Percutaneous cardiopulmonary bypass-supported coronary angioplasty in patients with unstable angina pectoris or myocardial infarction and a left ventricular ejection fraction ≤ 25%

Shawl, Fayaz A.; Quyyumi, Arshed A.; Bajaj, Sandeep; Hoff, Susan; Dougherty, Kathryn G.

doi:10.1016/s0002-9149(97)89127-8

Cited by 18 publications

(7 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, a number of techniques have been proposed for circulatory support during these high‐risk PCI, but no single approach has achieved wide acceptance so far [4–9]. Limited effectiveness of actual support and device‐related complications have hampered the widespread use of these devices [10].…”

Section: Introductionmentioning

confidence: 99%

Left ventricular unloading and concomitant total cardiac output increase by the use of percutaneous impella recover LP 2.5 assist device during high‐risk coronary intervention

Valgimigli

Steendijk

Sianos

et al. 2005

Cathet Cardio Intervent

View full text Add to dashboard Cite

A number of techniques have been proposed for circulatory support during high-risk percutaneous coronary interventions (PCI), but no single approach has achieved wide acceptance so far. We report on a patient with severe left ventricular (LV) impairment who underwent a PCI with the use of a new left ventricular assist device, the Impella Recover LP 2.5 system. The effects on global cardiac output were determined by thermodilution (TD) and LV pressure-volume loops obtained by conductance catheter. The activation of the pump resulted in a rapid and sustained unloading effect of the LV. At the same time, the continuous expulsion of blood into ascending aorta throughout the cardiac cycle produced by the pump resulted in an increase of systemic overall CO, measured by the TD technique, of 1.43 L/min. The procedure was uncomplicated and the patient remained uneventful at follow-up. Our single experience gives new input for future trials to assess the effect of the Impella Recover LP 2.5 assist device on outcome in this subset of patients.

show abstract

Section: Introductionmentioning

confidence: 99%

Left ventricular unloading and concomitant total cardiac output increase by the use of percutaneous impella recover LP 2.5 assist device during high‐risk coronary intervention

Valgimigli

Steendijk

Sianos

et al. 2005

Cathet Cardio Intervent

View full text Add to dashboard Cite

show abstract

“…This preventative support allows for precise diagnostic and therapeutic occlusive maneuvers {e.g., Intravascular ultrasound (IVUS), kissing balloon of bifurcated lesions} while preserving systemic perfusion pressures, and preventing both circulatory collapse and malignant arrhythmia 10)11). In one study, although it was from a small number of patients, the authors recommended prophylactic cardiopulmonary bypass support in unstable patients undergoing angioplasty with EF <25%, or in patients whose EF is low and in whom the only patent artery is the target of dilatation 12). Even stable patients with EF <20% may benefit from prophylactic cardiopulmonary bypass support 7).…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Cardiopulmonary Support-Supported Percutaneous Coronary Intervention: A Single Center Experience

Cho

Jang

et al. 2011

Korean Circ J

View full text Add to dashboard Cite

Background and ObjectivesPercutaneous cardiopulmonary support (PCPS) has proven to be a valuable technique in high-risk coronary patients undergoing percutaneous coronary intervention (PCI). However, there have been few studies on PCI associated with PCPS in Korea. We summarized our experience with PCPS-supported PCI.Subjects and MethodsWe retrospectively reviewed 19 patients with PCPS-supported PCI between August 2005 and June 2009. PCPS was used as an elective procedure for 10 patients with at least two of the following conditions: left-ventricular ejection fraction <35%, target vessel(s) supplying more than 50% of the viable myocardium, high risk surgical patients, and patients who refused coronary bypass surgery. In the remaining 9 patients PCPS was used as an emergency procedure, to stabilize and even resuscitate patients with acute myocardial infarction and cardiogenic shock, in order to attempt urgent PCI.ResultsAmong the 19 patients who were treated with PCPS-supported PCI, 11 (57.9%) survived and 8 (42.1%) patients did not. ST elevation myocardial infarction with cardiogenic shock was more prevalent in the non-survivors than in the survivors (75% vs. 27.3%, p=0.04). The elective PCPS-supported PCI was practiced more frequently in the survivors than in the non-survivors (72.7% vs. 25%, p=0.04). In the analysis of the event-free survival curve between elective and emergency procedures, there was a significant difference in the survival rate (p=0.025). Among the survivors there were more patients with multi-vessel disease, but a lower Thrombolysis in Myocardial Infarction grade in the culprit lesions was detected in the non-survivors, before PCI. Although we studied high-risk patients, there was no procedure-related mortality.ConclusionOur experience suggests that PCPS may be helpful in high risk patients treated with PCI, especially in elective cases. More aggressive and larger scale studies of PCPS should follow.

show abstract

“…[25][26][27][28][29][30][31][32][33] Several authors describe percutaneous cannulation with the aid of angiographic imaging, particularly those studies using closed chest percutaneous cardiopulmonary support in the catheter laboratory. 25 These authors have described their approach in detail, however the Seldinger technique is now ubiquitous in medicine.…”

Section: Seldinger Cannulationmentioning

confidence: 99%

“…Support is typically initiated through percutaneous femoral cannulation. [25][26][27][28][29][30][31][32][33] Applications have included: cardiac arrest in the catheter laboratory, high risk coronary angioplasty/valvuloplasty, cardiogenic shock, pulmonary embolism, intractable ventricular arrhythmias, hypothermia, near drowning, drug overdose and the reader is referred to reviews of the topic by Shawl and Baxley, 25 and Overlie, 26 Ludwig von Segesser 7 in particular gives a good review of ECLS comparing CPS and ECMO, and this will be discussed further below with respect to different approaches to cannulation in these two modalities.…”

Section: Indications and Outcomesmentioning

confidence: 99%

“…There has been a vast array of applications for this technology and the reader is referred elsewhere for a critical appraisal, sufficient to say the list includes: cardiogenic shock, angioplasty, donor preservation, bridging to ventricular assist devices, trauma, and apheresis. [25][26][27][28][29][30][31][32][33] As stated by von Segesser, 7 CPS is not generally suitable for long term use because of the comparatively small bore cannulas and simple technology, and its application is for brief support or as a bridge to definitive intervention. ECMO has different indications and is designed for longer term support using more sophisticated pumps, heaters, and oxygenators.…”

Section: Indications and Outcomementioning

confidence: 99%

See 1 more Smart Citation

Open and closed chest extrathoracic cannulation for cardiopulmonary bypass and extracorporeal life support: methods, indications, and outcomes

Field

Al-Alao

Mediratta

et al. 2006

Postgraduate Medical Journal

View full text Add to dashboard Cite

Extrathoracic cannulation to establish cardiopulmonary bypass has been widely applied in recent years and includes: (a) repeat surgery, (b) minimally invasive surgery, and (c) cases with diseased vessels such as porcelain, aneurysmal, and dissecting aorta. In addition, the success and relative ease of peripheral cannulation, among other technological advances, has permitted the development of closed chest extracorporeal life support, in the form of cardiopulmonary support and extracorporeal membrane oxygenation. With this development have come applications for cardiopulmonary bypass based support outside the traditional cardiac theatre setting, including emergency circulatory support for patients in cardiogenic shock and respiratory support for patients with severely impaired gas exchange. This review summarises the approach to extrathoracic cannulation for the generalist.

show abstract

Percutaneous cardiopulmonary bypass-supported coronary angioplasty in patients with unstable angina pectoris or myocardial infarction and a left ventricular ejection fraction ≤ 25%

Cited by 18 publications

References 23 publications

Left ventricular unloading and concomitant total cardiac output increase by the use of percutaneous impella recover LP 2.5 assist device during high‐risk coronary intervention

Left ventricular unloading and concomitant total cardiac output increase by the use of percutaneous impella recover LP 2.5 assist device during high‐risk coronary intervention

Percutaneous Cardiopulmonary Support-Supported Percutaneous Coronary Intervention: A Single Center Experience

Open and closed chest extrathoracic cannulation for cardiopulmonary bypass and extracorporeal life support: methods, indications, and outcomes

Contact Info

Product

Resources

About