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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Bibliographic Details
Published in:Catheterization and cardiovascular interventions Vol. 89; no. 4; pp. 672 - 675
Main Authors: Verma, Sanjay, Burkhoff, Daniel, O'Neill, William W.
Format: Journal Article
Language:English
Published: United States Wiley Subscription Services, Inc 01.03.2017
Subjects:
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
mechanical circulatory support
patient hemodynamics
patient-specific computational modeling
myocardial infarction
ISSN:1522-1946, 1522-726X
Online Access:Get full text
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Summary: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.
Bibliography:Disclosures: S.V. and W.O., none; D.B. educational grant (Abiomed, Inc.).
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ISSN:1522-1946
1522-726X
DOI:10.1002/ccd.26795