The Role of Hemodynamic Support in High-risk Percutaneous Coronary Intervention.

Patients with advanced age, complex coronary anatomy, and multiple comorbidities are often unsuitable for surgical revascularization. In this setting, hemodynamic support devices are used as an adjunct to percutaneous coronary intervention to maintain hemodynamic stability and enable optimal revascularization. This article provides an overview of percutaneous hemodynamic support devices currently used in clinical practice for high-risk percutaneous coronary intervention. These include the intra-aortic balloon pump, centrifugal pumps (TandemHeart, venous arterial extracorporeal membrane oxygenation), and micro-axial Impella pump. The hemodynamic effects, clinical evidence supporting improved outcomes and recovery of heart function, and associated complications with these devices are highlighted, with a special focus on Impella pumps.
Competing Interests: Disclosure: CS is a consultant for Abiomed. CT is a consultant for Boston Scientific and Abiomed. JRW is a consultant, proctor, speaker, and advisory board member for Boston Scientific and Abbott Vascular; a consultant, speaker, and advisory board member and has received research support for Abiomed; is on an advisory board for Phillips, and is a proctor for Asahi Intecc. DLM is a consultant and speaker, and has received research support from Abiomed. TGD is a speaker and proctor for Abiomed.
(Copyright © The Author(s), 2020. Published by Radcliffe Group Ltd.)