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Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
Published on: August 16, 2021
Percutaneous left ventricular assist device, TandemHeart, for high-risk percutaneous coronary revascularization. A
Claudio Giombolini1, Salvatore Notaristefano, Stefano Santucci
1Division of Cardiology, University of Perugia School of Medicine, Perugia, Italy. lab.emodinamica@ospedale.perugia.it
Insights
The TandemHeart device provides complete circulatory support during high-risk percutaneous coronary interventions (PCI) for patients with severe left ventricular dysfunction. This percutaneous transseptal ventricular assist device offers rapid deployment for both emergency and elective procedures.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Patients with severe left ventricular ejection fraction and high-risk coronary lesions face complications during percutaneous coronary interventions (PCI).
- Intra-aortic balloon pumps (IABP) offer limited hemodynamic support during high-risk PCI.
- Percutaneous left ventricular assist devices (pLVADs) provide superior circulatory support.
Observation:
- TandemHeart is a percutaneous transseptal ventricular assist device enabling rapid left ventricular support without surgical implantation.
- Six patients underwent emergency (n=3) or elective (n=3) TandemHeart placement before high-risk PCI between November 2003 and April 2005.
- The device was easily and rapidly deployed in all cases.
Findings:
- TandemHeart achieved complete cardiac assistance in all patients.
- The device facilitated successful high-risk PCI procedures.
Implications:
- TandemHeart offers a viable solution for complete circulatory support in high-risk PCI.
- This technology can be crucial for managing patients with severe left ventricular dysfunction undergoing complex interventions.
- Further research should explore long-term outcomes and broader applications of pLVADs.
Abstract:
Patients with severe depression of left ventricular ejection fraction and high-risk coronary lesions are at risk of developing complications during percutaneous coronary interventions (PCI). Intra-aortic balloon pump (IABP) is a support that helps the interventionalist in such hemodynamic complications during high-risk PCI, but it does not offer complete circulatory support. Instead, TandemHeart (Cardiac Assist, Pittsburg, PA, USA) is a percutaneous left ventricular assist device (pLVAD) that gives total left circulatory support and can be used for patients in cardiogenic shock or for elective PCI at high-risk. TandemHeart is a percutaneous transseptal ventricular assist device that allows a rapid percutaneous left ventricular support without the need for surgical implantation. Between November 2003 and April 2005, 6 patients admitted to our coronary care unit (CCU) underwent either emergency (n = 3) or elective (n = 3) placement of the TandemHeart device before a high-risk procedure. From our initial experience we conclude that the percutaneous transseptal ventricular assist device, TandemHeart, can be easily and rapidly deployed either in emergency or in elective high-risk PCI to achieve complete cardiac assistance.
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