PTCA with the use of cardiac assist devices: Risk stratification, short- and long-term results

Ferrari, Markus; Scholz, K. H.; Figulla, Hans R.

doi:10.1002/(sici)1097-0304(199607)38:3<242::aid-ccd4>3.0.co;2-8

Cited by 21 publications

(4 citation statements)

References 23 publications

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“…Die rasche technische Entwicklung stellte interventionellen Kardiologen auch perkutane VAD (pVAD) zur Verfügung, die innerhalb wenigen Minuten im Herzkatheterlabor über einen femoralen Zugang eingesetzt werden können. Neben KS bei AMI [45] finden VAD im Rahmen der Hochrisiko-PCI als vorübergehende Maßnahme Anwendung, wenn das Zielgefäß mehr als die Hälfte des vitalen Myokards versorgt und die linksventrikuläre Funktion schwer eingeschränkt ist [12,13,32,48].…”

Section: Ventrikuläre Unterstützungssysteme (Vad ["Ventricular Assistunclassified

Möglichkeiten und Grenzen der interventionellen Therapie bei akuter Herzinsuffizienz bei koronarer Herzerkrankung

Poerner

Ferrari²,

Brehm³

et al. 2006

Herz

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Acute heart failure and especially its most severe form, cardiogenic shock, remain the final common pathway to death in a substantial number of patients with acute myocardial infarction (MI). Several studies demonstrated that mechanical reperfusion of occluded coronary arteries by percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery improves survival in patients with acute MI and cardiogenic shock. There is strong evidence that intraaortic balloon pump (IABP) support and ventricular assist devices can stabilize hemodynamics in these patients so that revascularization procedures can be safely performed. This article provides an overview of the therapeutic strategies for acute MI with cardiogenic shock, with focus on the role and particularities of different devices used as mechanical circulatory support in these patients.

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Section: Ventrikuläre Unterstützungssysteme (Vad ["Ventricular Assistunclassified

Möglichkeiten und Grenzen der interventionellen Therapie bei akuter Herzinsuffizienz bei koronarer Herzerkrankung

Poerner

Ferrari²,

Brehm³

et al. 2006

Herz

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“…Die intra-aortale Ballonpulsation (IABP) ist das am häufigsten eingesetzte Herz-Kreislauf-Unterstützungssystem in der Kardiologie (7). Bei diesem Verfahren wird in Seldinger-Technik ein 8F Katheter über die Arteria femoralis bis an den Übergang von Aortenbogen zu Aorta descendens vorgeschoben (10) (5).…”

Section: Intra-aortale Ballonpulsation (Iabp)unclassified

Mechanische Herz-Kreislauf-Unterstützung in der Kardiologie

Ferrari

Figulla²

2005

Dtsch med Wochenschr

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One out of 13 patients with an acute myocardial infarction is endangered of cardiogenic shock. In addition, acute valvular leakage, shunt vitiae, and acute myocarditis can lead to acute myocardial failure. As a therapeutic option, mechanical assist devices offer cardiac support and hemodynamic stabilization under these circumstances. The following minimal-invasive devices are used in cardiology and intensive care medicine: intra-aortic balloon pulsation (IABP), intra-vascular axial screw pumps, extra-corporal centrifugal pumps with and without additional membrane oxygenator. The IABP improves left ventricular function by a systolic reduction of the after-load, and an increase of diastolic blood pressure dependent on myocardial function. In contrast, axial screw pumps and centrifugal pumps can provide circulatory support independently of myocardial function. Mechanical assist devices can prevent irreversible damage not only by offering a reduction of myocardial work load, but also by improving organ perfusion in cardiogenic shock situations. Another indication for mechanical circulatory support depicts high-risk coronary angioplasty if the left ventricular ejection fraction is severely reduced or the target vessel supplies more than 50 % of vital myocardium. In case of irreversible heart failure, turbine pumps or centrifugal pumps offer a stabilization for the patient's transfer to a cardiac surgery center. They can also be used for bridging to heart transplantation in acute situations. Technical improvements will enhance the use of mechanical assist devices in the near future. Especially the development of portable emergency devices will enrich therapeutic possibilities in cardiology and intensive care medicine.

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“…The risk of hemodynamic collapse can be identified according to the amount of vital myocardium supplied by the target vessel (2). Satisfying acute results as well as good long-term results can be achieved in selected patients receiving percutaneous coronary angioplasty (PCI) under hemodynamic stabilization by a percutaneous circulatory assist device (3). While intra-aortic balloon counter-pulsation (IABP) provides sufficient support in some high risk patients, PCI of the left main coronary artery should be performed under circulatory support independent of the left ventricular function (4,5).…”

Section: Introductionmentioning

confidence: 99%

First use of a novel plug-and-play percutaneous circulatory assist device for high-risk coronary angioplasty

et al. 2008

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PTCA with the use of cardiac assist devices: Risk stratification, short- and long-term results

Cited by 21 publications

References 23 publications

Möglichkeiten und Grenzen der interventionellen Therapie bei akuter Herzinsuffizienz bei koronarer Herzerkrankung

Möglichkeiten und Grenzen der interventionellen Therapie bei akuter Herzinsuffizienz bei koronarer Herzerkrankung

Mechanische Herz-Kreislauf-Unterstützung in der Kardiologie

First use of a novel plug-and-play percutaneous circulatory assist device for high-risk coronary angioplasty

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