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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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The increasing importance of percutaneous mechanical circulatory assist device therapy in heart failure management

Ricardo A Weis, Patrick A Devaleria, Sarang Koushik

  • 1Department of Anesthesiology, Division of Cardiovascular and Thoracic Anesthesiology, Mayo Clinic Hospital, Phoenix, Arizona, USA.

Annals of Cardiac Anaesthesia
|October 7, 2015
PubMed

Insights

Percutaneous Impella CP placement via the axillary artery offers a viable short-term cardiac support solution. This approach aids in improving end-organ perfusion for patients with congenital heart disease awaiting heart transplantation.

Area of Science:

  • Cardiology
  • Adult Congenital Heart Disease
  • Mechanical Circulatory Support

Background:

  • Adult congenital heart disease (CHD) survival is increasing due to medical advances.
  • Transposition of the great vessels (TGV) is a common cyanotic CHD where the right ventricle acts as the systemic ventricle.
  • Systemic ventricular failure is a frequent complication in TGV patients, often necessitating heart transplantation.

Observation:

  • Hemodynamic decompensation in TGV patients can be rapid and challenging to manage.
  • Percutaneous left ventricular assist devices (LVADs), such as the Impella (Abiomed, Mass, USA), are increasingly utilized.
  • These devices offer easier insertion, both in and out of the operating room.

Findings:

  • Axillary artery approach for Impella (IMP) CP placement is demonstrated as a feasible option.
  • This method provides effective short-term cardiac support.
  • It leads to improved end-organ perfusion in patients with TGV.

Implications:

  • Axillary artery Impella CP placement is a suitable strategy for bridging TGV patients to heart transplantation.
  • This technique can stabilize patients with hemodynamic instability.
  • It offers a less invasive alternative for mechanical circulatory support in complex CHD cases.
Abstract

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