[Artificial circulation in high-risk percutaneous coronary interventions].

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Cardiopulmonary Support

Background:

• Cardiovascular surgeons face challenges with extremely high-risk patients undergoing percutaneous coronary interventions (PCIs) or myocardial revascularization.
• Artificial circulation (AC), particularly extracorporeal membrane oxygenation (ECMO), is proposed for supporting high-risk PCIs.

Purpose of the Study:

• To share experience with standard AC systems and modified mini-circuit systems for high-risk PCIs.
• To evaluate the efficacy of AC support in complex coronary interventions.

Main Methods:

• Ten patients with extremely high-risk coronary artery lesions or critical conditions underwent PCIs supported by AC.
• Standard AC systems and modified mini-circuit systems were utilized.
• Patient data were collected between October 2011 and November 2014.

Main Results:

• PCIs were successfully performed in high-risk patients, including those with severe coronary artery disease and comorbidities.
• Cardiac arrhythmias (ventricular fibrillation, asystole) occurred in some patients but resolved spontaneously with AC support.
• A single mortality occurred in a patient in clinical death upon admission, despite ongoing resuscitation.

Conclusions:

• Assisted circulation methods using standard and mini-circuit AC systems are effective for high-risk PCIs.
• These techniques facilitate complex interventions even in centers lacking specialized ECMO equipment or experience.