Safety and Effectiveness of MANTA Vascular Closure Device After Large-Bore Mechanical Circulatory Support: Real-World Experience

Gupta, Ankur; Fouad, Lina; Basir, Mir B.; Neupane, Saroj; Zaidan, Mohammed; Koenig, Gerald; Alqarqaz, Mohammad; Villablanca, Pedro A.; O’Neill, William W.; Alaswad, Khaldoon

doi:10.1016/j.carrev.2020.03.032

Cited by 12 publications

(6 citation statements)

References 4 publications

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“…It can be assumed that standardizations in implantation and explantation procedures (eg, more frequent use of ultrasound for implantation and suture-based interventional techniques for explantation) could help to reduce the risk of such events. 3 However, randomized data needs to not only confirm the overall efficacy of LV unloading but also determine its safety profile. In this regard, Meuwese et al make the valid point that active LV unloading by Impella is probably not a one-size-fits-all approach, and that we need dedicated criteria to identify patients with cardiogenic shock who have an optimal benefit-risk ratio with this approach.…”

Section: Response To Letter To the Editormentioning

confidence: 99%

Response by Schrage and Westermann to Letters Regarding Article, “Left Ventricular Unloading Is Associated With Lower Mortality in Patients With Cardiogenic Shock Treated With Venoarterial Extracorporeal Membrane Oxygenation: Results From an International, Multicenter Cohort Study”

Schrage

Westermann

2021

Circulation

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Section: Response To Letter To the Editormentioning

confidence: 99%

Response by Schrage and Westermann to Letters Regarding Article, “Left Ventricular Unloading Is Associated With Lower Mortality in Patients With Cardiogenic Shock Treated With Venoarterial Extracorporeal Membrane Oxygenation: Results From an International, Multicenter Cohort Study”

Schrage

Westermann

2021

Circulation

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“…60 A recent single-centre study assessed the MANTA VCD in 22 patients receiving MCS for HRPCI (68%) or cardiogenic shock (32%), with a majority receiving pLVADs. 61 Technical success was reported in 96% of patients. These results were achieved despite constituting the first experience for most operators.…”

Section: Vascular Closure Techniques and Devicesmentioning

confidence: 98%

Strategies for Reducing Vascular and Bleeding Risk for Percutaneous Left Ventricular Assist Device-supported High-risk Percutaneous Coronary Intervention

Vetrovec¹,

Kaki²,

Wollmuth³

et al. 2022

Heart International

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In patients at high risk for haemodynamic instability during percutaneous coronary intervention (PCI), practitioners are increasingly opting for prophylactic mechanical circulatory support, such as the Impella® heart pump (Abiomed, Danvers, MA, USA). Though Impellasupported high-risk PCI (HRPCI) ensures haemodynamic stability during the PCI procedure, access-related complication rates have varied significantly in published studies. Reported variability in complication rates relates to many factors, including anticoagulation practices, access and closure strategy, post-procedure care and variations in event definitions. This article aims to outline optimal strategies to minimize vascular and bleeding complications during Impella-supported HRPCI based on previously identified clinical, procedural and postprocedural risk factors. Practices to reduce complications include femoral skills training, standardized protocols to optimize access, closure, anticoagulation management and post-procedural care, as well as the application of techniques and technological advances. Protocols integrating these strategies to mitigate access-related bleeding and vascular complications for Impella-supported procedures can markedly limit vascular access risk as a barrier to appropriate large-bore mechanical circulatory support use in HRPCI.

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“…A growing body of evidence suggests a favorable clinical outcome of VCD in the aforementioned clinical settings. 1 2 3 4 5 6 7 8 9 10…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Cannulation of Femoral Vessels in Minimally Invasive Cardiac Surgery

Sugimura

Jandali

Immohr

et al. 2022

Thorac Cardiovasc Surg

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Objective Despite the recent trend of access miniaturization in minimally invasive cardiac surgery (MICS) surgical “cut down (CD)” for femoral cannulation remains the standard at many centers. Percutaneous vascular closure (PVC) devices have recently been introduced for minimizing invasiveness during interventional diagnostic and therapy. This report summarizes the initial experience with this new approach in the setting of MICS, with a special focus on safety and advantages. Methods Percutaneous cannulation with a standard protocol including preoperative computer tomography imaging and intraoperative point-of-care ultrasound guidance was performed in 93 consecutive patients from September 2018 until February 2020, while conventional “CD” procedure performed in 218 patients in the previous period. We analyzed patients' characteristics and compared access site complications of PVC group versus conventional “CD” group. Results As far as operative/postoperative outcome, the duration of intensive care unit stay as well as hospital stay was statistically shorter in PVC compared with CD (CD vs. PVC: 2.74 ± 3.83 vs. 2.16 ± 2.01 days, p < 0.01, 16.7 ± 8.75 vs. 13.0 ± 4.96 days, p < 0.001, respectively). Further, we found no femoral infection or lymphocele in the PVC group, whereas 4 cases of wound complications were observed in the CD group. Conclusion According to our results, percutaneous closure system for femoral vessels in MICS seems to be beneficial with the assist of preoperative computed tomography and intraoperative Doppler guidance.

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Safety and Effectiveness of MANTA Vascular Closure Device After Large-Bore Mechanical Circulatory Support: Real-World Experience

Cited by 12 publications

References 4 publications

Response by Schrage and Westermann to Letters Regarding Article, “Left Ventricular Unloading Is Associated With Lower Mortality in Patients With Cardiogenic Shock Treated With Venoarterial Extracorporeal Membrane Oxygenation: Results From an International, Multicenter Cohort Study”

Response by Schrage and Westermann to Letters Regarding Article, “Left Ventricular Unloading Is Associated With Lower Mortality in Patients With Cardiogenic Shock Treated With Venoarterial Extracorporeal Membrane Oxygenation: Results From an International, Multicenter Cohort Study”

Strategies for Reducing Vascular and Bleeding Risk for Percutaneous Left Ventricular Assist Device-supported High-risk Percutaneous Coronary Intervention

Percutaneous Cannulation of Femoral Vessels in Minimally Invasive Cardiac Surgery

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