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Cardiac intensive care management of high-risk percutaneous coronary intervention using the venoarterial ECMO support

Marco Zuin1, Gianluca Rigatelli2, Ramesh Daggubati3

  • 1Faculty of Medicine, Section of Internal and Cardiopulmonary Medicine, University of Ferrara, Ferrara, Italy.

Heart Failure Reviews
|November 3, 2019
PubMed

Insights

High-risk percutaneous coronary intervention (HR-PCI) now uses venoarterial ECMO (VA-ECMO) for circulatory support. This review reappraises managing these complex HR-PCI patients on VA-ECMO using current literature.

Area of Science:

  • Critical Care Cardiology
  • Interventional Cardiology
  • Mechanical Circulatory Support

Background:

  • High-risk percutaneous coronary intervention (HR-PCI) necessitates a multidisciplinary approach.
  • Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is utilized for temporary mechanical circulatory support (MCS) in HR-PCI.
  • Patient complexity and technological advancements drive critical care cardiology evolution.

Purpose of the Study:

  • To reappraise the management of HR-PCI patients undergoing VA-ECMO.
  • To consolidate current literature data for guiding HR-PCI patient care with VA-ECMO.

Main Methods:

  • Narrative review of existing literature.
  • Analysis of data concerning HR-PCI patients supported by VA-ECMO.

Main Results:

  • Management of HR-PCI patients on VA-ECMO presents significant complexities.
  • Lack of specific guidelines for HR-PCI patients on VA-ECMO complicates care.

Conclusions:

  • VA-ECMO is a vital MCS for select HR-PCI patients.
  • Further research and specific recommendations are needed for optimizing HR-PCI patient outcomes on VA-ECMO.

Keywords:
Critical careHemodynamic monitoringHigh-risk PCIIntensive care unitMechanical circulatory supportShockVA-ECMO

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