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Updated: Mar 29, 2026
Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
Published on: August 16, 2021
Percutaneous coronary intervention with the TandemHeart™ percutaneous left ventricular assist device support: Six
Angelo Nascimbene1,2,3, Pranav Loyalka1,2,3, Igor D Gregoric1,2,3
1Department of Cardiology, Center for Cardiac Support, Texas Heart Institute at St. Luke's Health System, Houston, Texas.
Insights
TandemHeart™ assistance during percutaneous coronary intervention (PCI) offers a viable revascularization option for high-risk patients. Outcomes varied by presentation urgency, with elective cases showing the best long-term survival rates.
Area of Science:
- Cardiovascular Interventions
- Medical Device Technology
- Interventional Cardiology
Background:
- Percutaneous coronary intervention (PCI) and aorto-coronary bypass pose substantial risks for patients with comorbidities.
- The TandemHeart™ percutaneous left ventricular assist device is utilized for high-risk PCI cases.
- This device is employed when conventional revascularization methods are contraindicated.
Purpose of the Study:
- To evaluate the outcomes of TandemHeart™ assistance during PCI.
- To assess the relationship between pre-procedural risk factors and patient outcomes.
- To analyze outcomes in patients ineligible for surgical revascularization.
Main Methods:
- Retrospective analysis of 626 PCIs performed between 2005 and 2011.
- Focus on 74 interventions utilizing TandemHeart™ support.
- Evaluation of mortality, morbidity, and 6-year survival rates based on presentation status (elective, urgent, emergent, emergent salvage).
Main Results:
- 30-day survival rates ranged from 94% (elective) to 55% (emergent salvage).
- 6-year survival rates varied significantly: 68% (elective) down to 31% (emergent).
- Successful weaning from mechanical support was high in elective/urgent groups (100%) but lower in emergent/emergent salvage groups (84% and 55%, respectively).
Conclusions:
- TandemHeart™ assisted PCI is a feasible revascularization strategy for patients with profound cardiogenic shock.
- It provides a viable option for extremely high-risk interventions due to complex coronary anatomy.
- The study highlights the importance of patient selection and presentation status for successful outcomes.
Objectives:
Our study was designed to evaluate the outcomes of TandemHeart™ assistance during percutaneous coronary intervention, specifically in relationship to pre-procedural clinical and hemodynamic risk factors in patients ineligible for surgical revascularization.
Background:
We have used the TandemHeart™ percutaneous left ventricular assist device during percutaneous coronary intervention (PCI) in patients for whom conventional PCI and aorto-coronary bypass would pose substantial risk owing to comorbidities and/or clinical presentations.
Methods:
We retrospectively analyzed data from 626 consecutive PCIs at the Texas Heart Institute from 2005 to 2011. Among these, 74 interventions were performed with TandemHeart™ support. Mortality and morbidity were analyzed in relationship to presentation status (elective, urgent, emergent, or emergent salvage), and then we recorded outcomes and survival rates over the course of six years.
Results:
At 30 days after PCI, survival rates were 94%, 88%, 79%, and 55% in the elective, urgent, emergent, and emergent salvage groups, respectively. Survival rates at one year were at 75% in the elective, 64% in the urgent, 52% in the emergent, and 45% in the emergent salvage groups. Survival rates at 6 years were 68% in the elective, 53% in the urgent, 31% in the emergent, and 41% in the emergent salvage groups, respectively. In elective and urgent groups, successful weaning from mechanical support was possible in all patients. In the emergent and emergent salvage groups, successful weaning from mechanical support was possible in 84% and 55% of patients, respectively.
Conclusions:
TandemHeart™ assisted PCI is a viable option for revascularization in cases of profound cardiogenic shock or extremely risky intervention due to complex anatomy. © 2015 Wiley Periodicals, Inc.
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