Circulatory Support Devices in Clinical Cardiology

Abstract

Percutaneous transluminal coronary angioplasty (PTCA) has extended its indications to multivessel disease and impaired left-ventricular function. In these patients, failed PTCA may induce cardiogenic shock or arrest. Coronary and circulatory support devices such as antegrade perfusion catheters, coronary sinus retrograde perfusion, intraaortic balloon pumping, left-ventricular pumping (Hemopump^TM) and percutaneously applicable cardiopulmonary support are the tools necessary for high-risk PTCAs. The devices are a prerequisite for developing a minimally invasive cardiac surgery.

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

“…Using 15F arterial cannula in combination with 17F venous cannula allowed flow rates up to 3.5 l/min. This technique of percutaneous cannulation can be also performed in patients with circulatory arrest being under external cardiac compression (6,12,13). While standard pCPS devices require 20 to 40 min for setup and priming, the novel modular construction of the LIFEBRIDGE is ready to use within 5 min.…”

“…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). Percutaneous circulatory support including a centrifugal pump and an oxygenator has been therefore established in very high risk emergency cases (6,7). However, these so-called percutaneous cardiopulmonary support devices (pCPS) still require technical support by a trained technician who needs more than 30 min for setup of the machinery.…”

Simplified Retroperfusion System Preserves the Myocardial Function During Acute Coronary Artery Occlusion

“…tion.lfthe lesion is untreated, enzyme leakageoccursand myocardial necrosis de veiops. lt is of vita l importance to resume the coronarybloodflow to reduce the areaof mycardial necrosis.To reduce infarct size various perfusion methods have been developed to treat the adverse circulatory conditions (1,2,3,4). Of the se methods retroperf usion appears to be an alternative method to meet th e metabolic demand of the invo lved ischemic partof the myocardium.…”