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Published on: June 12, 2021
The science behind percutaneous hemodynamic support: a review and comparison of support strategies
Daniel Burkhoff1, Srihari S Naidu
1Division of Cardiology, Columbia University School of Medicine, New York, New York, USA. db59@columbia.edu
Insights
Temporary percutaneous cardiac support offers benefits for various cardiovascular conditions. The ideal device ensures safety, ease of use, versatility, hemodynamic support, and myocardial protection.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Biomedical Engineering
Background:
- Temporary percutaneous cardiac support is crucial for patients with critical cardiovascular conditions.
- Conditions include acute decompensated heart failure, myocarditis, myocardial infarction with cardiogenic shock, and high-risk percutaneous coronary intervention.
- Current devices aim for safety, ease of use, and versatility.
Purpose of the Study:
- To review the scientific principles governing hemodynamic effectiveness of cardiac support devices.
- To examine principles for myocardial protection offered by acute support devices.
- To define the characteristics of an ideal percutaneous cardiac support device.
Main Methods:
- Review of scientific literature on hemodynamic principles.
- Analysis of studies on myocardial protection strategies.
- Evaluation of device characteristics against clinical needs.
Main Results:
- Hemodynamic effectiveness is paramount for supporting failing hearts.
- Myocardial protection strategies aim to prevent ischemic damage during support.
- An ideal device balances support, safety, usability, and versatility.
Conclusions:
- Percutaneous cardiac support is vital across diverse cardiovascular emergencies.
- Optimizing device design requires understanding hemodynamic and ischemic protection principles.
- Future devices should prioritize comprehensive patient support and clinical adaptability.
Abstract:
Patients in a variety of cardiovascular disease states may benefit from temporary percutaneous cardiac support, including those in acute decompensated heart failure, fulminant myocarditis, acute myocardial infarction with or without cardiogenic shock and those undergoing high-risk percutaneous coronary intervention. The ideal percutaneous cardiac support device is safe, easy to use and versatile enough to meet the needs of various clinical situations and patient cohorts. In addition, it should provide maximal hemodynamic support and protection against myocardial ischemia. With these goals in mind, the scientific principles that govern hemodynamic effectiveness and myocardial protection as they pertain to acute support devices are reviewed.
