Document Detail

High-risk PCI in acute coronary syndromes with Impella LP 2.5 device support.
MedLine Citation:
PMID:  20826017     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVES: To evaluate feasibility, safety, efficacy as well as acute and short-term outcome of hemodynamically supported percutaneous coronary intervention (PCI) by a percutaneous, catheter-based left ventricular assist device (LVAD) (Impella LP 2.5, Abiomed Europe GmbH, Aachen, Germany) in a high-risk patient population with acute coronary syndrome.
BACKGROUND: Although hemodynamic support by intraaortic balloon pump favorably affects myocardial oxygen supply and demand, it has modest effects on cardiac output, providing passive support only. In contrast, the Impella LP 2.5 microaxial pump, which is placed within the left ventricular outflow tract and actively ejects blood into the ascending aorta, might offer additional hemodynamic support and thereby procedural safety during PCI.
METHODS: Thirty-eight consecutive high-risk patients (mean age, 69.7±10.3years, logistic EuroSCORE, 22.4±14.9%) with unstable angina pectoris or non-ST-segment elevation myocardial infarction and severe three-vessel-disease were included in the study. Clinical and laboratory examinations were performed at baseline as well as at 6, 24 and 48h after the procedure and 30days after discharge.
RESULTS: Device insertion and explantation was feasible in all patients without vascular complications and continuous hemodynamic stability was obtained during PCI. PCI was uneventfully performed in all but one patient for technical reasons. One non procedure-related death occurred 7days after the intervention, accounting for a total 30-day mortality of 2.86%. Other major cardiac or cerebrovascular events did not occur.
CONCLUSIONS: LVAD support using a percutaneous microaxial flow pump is a promising and safe approach for high-risk PCI providing good short-term results.
Konstantinos E Iliodromitis; Philipp Kahlert; Bjorn Plicht; Andreas-Claudius Hoffmann; Holger Eggebrecht; Raimund Erbel; Thomas F Konorza
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Publication Detail:
Type:  Journal Article     Date:  2010-09-09
Journal Detail:
Title:  International journal of cardiology     Volume:  153     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  59-63     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Department of Cardiology, West German Heart Center Essen, University Duisburg-Essen, Hufelandstr. 55, D-45122 Essen, Germany.
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