Left ventricular assist devices in acute cardiovascular care patients and high-risk percutaneous coronary interventions

Gómez-Polo, Juan Carlos; Villablanca, Pedro; Ramakrishna, Harish

doi:10.24875/recice.m20000130

Cited by 1 publication

(6 citation statements)

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“…The TandemHeart is an external temporary device based on the insertion of a cannula (21-Fr cannula) through the interatrial septum to the left atrium. It is composed of three subsystems (a transseptal cannula, the centrifugal blood pump, and an arterial cannula) [ 8 , 39 ]. Oxygenated blood is pumped out from the left atrium to a centrifugal pump which continuously returns the blood to the femoral artery through a 12 Fr cannula or to the iliac artery through a 5–17 Fr cannula ( Figure 2 ).…”

Section: Cardioprotective Devices That Unload the Heartmentioning

confidence: 99%

“…Oxygenated blood is pumped out from the left atrium to a centrifugal pump which continuously returns the blood to the femoral artery through a 12 Fr cannula or to the iliac artery through a 5–17 Fr cannula ( Figure 2 ). This device is capable of generating a continuous flow of up to 4 L/min output [ 8 , 39 ]. Moreover, the addition of an oxygenator makes it possible for respiratory support [ 64 ].…”

Section: Cardioprotective Devices That Unload the Heartmentioning

confidence: 99%

Section: Cardioprotective Devices That Unload the Heartmentioning

confidence: 99%

“…The Impella devices consist of a catheter inserted through femoral access to the left ventricle, crossing the aortic valve [ 8 ]. This catheter pumps oxygenated blood from the left ventricle to the ascending aorta via an integrated transvalvular axial pump ( Figure 2 ) [ 8 ]. Different models are available depending on the supply they provide: Impella 2.5 (2.5 L/min flow), Impella CP (4 L/min flow), and Impella 5.0 (5 L/min flow) [ 8 ].…”

Section: Cardioprotective Devices That Unload the Heartmentioning

confidence: 99%

“…There exist many devices to curb the adverse effects and prevalence of cardiac procedure-related injuries. These devices act at different levels; either providing or improving hemodynamic support such as TandemHeart, Impella family devices, veno-arterial extracorporeal membrane oxygenation (VA-ECMO), intra-aortic balloon pump (IABP), etc; or by inducing cardioplegia, thus preserving myocardial properties such as topic cardioprotective cooling devices [ 8 , 9 , 10 , 11 ]. Although these devices and approaches have shown some promising results and are currently widely used for treating other conditions such as the use of VA-ECMO in respiratory failure, their uses in treating or preventing hemodynamic alterations in regard to cardiac surgery or percutaneous interventions still bear some important adverse effects that do not permit diminish of mortality in high-risk patients undergoing cardiac surgery or percutaneous interventions [ 12 , 13 , 14 , 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

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The Use of Cardioprotective Devices and Strategies in Patients Undergoing Percutaneous Procedures and Cardiac Surgery

et al. 2023

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In the United States, about one million people are seen to visit the operating theater for cardiac surgery annually. However, nearly half of these visits result in complications such as renal, neurological, and cardiac injury of varying degrees. Historically, many mechanisms and approaches have been explored in attempts to reduce injuries associated with cardiac surgery and percutaneous procedures. Devices such as cardioplegia, mechanical circulatory support, and other methods have shown promising results in managing and preventing life-threatening cardiac-surgery-related outcomes such as heart failure and cardiogenic shock. Comparably, cardioprotective devices such as TandemHeart, Impella family devices, and venoarterial extracorporeal membrane oxygenation (VA-ECMO) have also been proven to show significant cardioprotection through mechanical support. However, their use as interventional agents in the prevention of hemodynamic changes due to cardiac surgery or percutaneous interventions has been correlated with adverse effects. This can lead to a rebound increased risk of mortality in high-risk patients who undergo cardiac surgery. Further research is necessary to delineate and stratify patients into appropriate cardioprotective device groups. Furthermore, the use of one device over another in terms of efficacy remains controversial and further research is necessary to assess device potential in different settings. Clinical research is also needed regarding novel strategies and targets, such as transcutaneous vagus stimulation and supersaturated oxygen therapy, aimed at reducing mortality among high-risk cardiac surgery patients. This review explores the recent advances regarding the use of cardioprotective devices in patients undergoing percutaneous procedures and cardiac surgery.

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Section: Cardioprotective Devices That Unload the Heartmentioning

confidence: 99%