Avoiding hemodynamic collapse during high‐risk percutaneous coronary intervention: Advanced hemodynamics of impella support
The rate of performing primary percutaneous coronary intervention in patients with complex coronary artery disease is increasing. The use of percutaneous mechanical circulatory support devices provides critical periprocedural hemodynamic support. Mechanical support has increased the safety and effic...
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| Published in: | Catheterization and cardiovascular interventions Vol. 89; no. 4; pp. 672 - 675 |
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| Main Authors: | , , |
| Format: | Journal Article |
| Language: | English |
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United States
Wiley Subscription Services, Inc
01.03.2017
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| ISSN: | 1522-1946, 1522-726X |
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| Abstract | The rate of performing primary percutaneous coronary intervention in patients with complex coronary artery disease is increasing. The use of percutaneous mechanical circulatory support devices provides critical periprocedural hemodynamic support. Mechanical support has increased the safety and efficacy of interventional procedures in this high‐risk patient population. Predicting patient response to the selected intervention can be clinically challenging. Here we demonstrate a case where complete hemodynamic collapse during PCI was avoided by mechanical support provided by the Impella device. Further, we employ a comprehensive cardiovascular model to predict ventricular function and patient hemodynamics in response to the procedure. New computational tools may help interventionists visualize, understand, and predict the multifaceted hemodynamic aspects of these high risk procedures in individual patients. © 2016 Wiley Periodicals, Inc. |
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| AbstractList | The rate of performing primary percutaneous coronary intervention in patients with complex coronary artery disease is increasing. The use of percutaneous mechanical circulatory support devices provides critical periprocedural hemodynamic support. Mechanical support has increased the safety and efficacy of interventional procedures in this high-risk patient population. Predicting patient response to the selected intervention can be clinically challenging. Here we demonstrate a case where complete hemodynamic collapse during PCI was avoided by mechanical support provided by the Impella device. Further, we employ a comprehensive cardiovascular model to predict ventricular function and patient hemodynamics in response to the procedure. New computational tools may help interventionists visualize, understand, and predict the multifaceted hemodynamic aspects of these high risk procedures in individual patients. © 2016 Wiley Periodicals, Inc. |
| Author | Verma, Sanjay Burkhoff, Daniel O'Neill, William W. |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/27658747$$D View this record in MEDLINE/PubMed |
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| Keywords | mechanical circulatory support patient hemodynamics patient-specific computational modeling myocardial infarction |
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| Notes | Disclosures: S.V. and W.O., none; D.B. educational grant (Abiomed, Inc.). ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 |
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| References | 2012; 80 2015; 3 2012; 126 2015; 61 2015; 66 1991; 83 2016; 22 |
| References_xml | – volume: 126 start-page: 1717 year: 2012 end-page: 1727 article-title: A prospective, randomized clinical trial of hemodynamic support with Impella 2.5 versus intra‐aortic balloon pump in patients undergoing high‐risk percutaneous coronary intervention: The PROTECT II study publication-title: Circulation – volume: 3 start-page: 873 year: 2015 end-page: 882 article-title: Mechanical pre‐conditioning with acute circulatory support before reperfusion limits infarct size in acute myocardial infarction publication-title: JACC Heart Failure – volume: 80 start-page: 816 year: 2012 end-page: 829 article-title: The science behind percutaneous hemodynamic support: A review and comparison of support strategies publication-title: Catheter Cardiovasc Intervent Off J Soc Cardiac Angiogr Intervent – volume: 22 year: 2016 article-title: Cardiovascular simulation of heart failure pathophysiology and therapeutics publication-title: J Cardiac Failure – volume: 61 start-page: 301 year: 2015 end-page: 306 article-title: Hemodynamic effects of left atrial or left ventricular cannulation for acute circulatory support in a bovine model of left heart injury publication-title: ASAIO J – volume: 83 start-page: 681 year: 1991 end-page: 688 article-title: Myocardial stunning and hibernation. The physiology behind the colloquialisms publication-title: Circulation – volume: 66 start-page: 2663 year: 2015 end-page: 2674 article-title: Hemodynamics of mechanical circulatory support publication-title: J Am Coll Cardiol |
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| SubjectTerms | Aged, 80 and over Electrocardiography Equipment Design Female Heart-Assist Devices Hemodynamics - physiology Humans Intraoperative Complications - prevention & control mechanical circulatory support myocardial infarction Non-ST Elevated Myocardial Infarction - physiopathology Non-ST Elevated Myocardial Infarction - surgery patient hemodynamics patient‐specific computational modeling Percutaneous Coronary Intervention - methods Shock - physiopathology Shock - prevention & control |
| Title | Avoiding hemodynamic collapse during high‐risk percutaneous coronary intervention: Advanced hemodynamics of impella support |
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