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Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
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Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock

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High-risk coronary intervention with a percutaneous ventricular assist device in the presence of an unstable left

Navin K Kapur1, Chris Pan, Barath Krishnamurthy

  • 1Tufts Medical Center, Division of Cardiology, 800 Washington Street, Box No. 80, Boston, MA 02111, USA. nkapur@tuftsmedicalcenter.org

The Journal of Invasive Cardiology
|July 7, 2010
PubMed

Insights

Left ventricular thrombus, a common myocardial infarction complication, was managed with a percutaneous left ventricular assist device (pVAD) during high-risk percutaneous coronary intervention (PCI). This case highlights pVAD utility in complex scenarios involving LV thrombus.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiovascular Devices

Background:

  • Left ventricular (LV) thrombus is a frequent complication following myocardial infarction (MI).
  • High-risk percutaneous coronary intervention (PCI) often requires mechanical circulatory support.
  • Percutaneous left ventricular assist devices (pVADs) and intra-aortic balloon pumps (IABPs) are available support options.

Observation:

  • An elderly patient presented with critical double-vessel disease and severely depressed LV function.
  • A large, unstable LV thrombus was identified in the context of a mechanical fall causing spinal cord compression.
  • The patient required high-risk PCI for their coronary artery disease.

Findings:

  • The TandemHeart pVAD was successfully utilized to provide hemodynamic support during high-risk PCI.
  • This intervention was performed in the presence of a significant and unstable LV thrombus.
  • The use of pVAD facilitated the management of complex coronary anatomy and LV dysfunction.

Implications:

  • This case demonstrates the feasibility and potential benefit of using a pVAD in patients with LV thrombus undergoing high-risk PCI.
  • pVADs may offer a viable option for hemodynamic stabilization in complex cardiovascular presentations.
  • Further research may explore the role of pVADs in mitigating risks associated with PCI in patients with LV thrombus.

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