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Simultaneous therapy with pressure-controlled intermittent coronary sinus occlusion and left ventricular support

Erick D Martinez Maldonado1, Guillermo Bastos Fernandez1, Berenice Caneiro Queija1

  • 1Cardiology Department, Hospital Álvaro Cunqueiro, University Hospital of Vigo, Estrada Clara Campoamor 341, Vigo, Pontevedra 36312, Spain.

European Heart Journal. Case Reports
|October 18, 2024
PubMed

Insights

This study reports the first simultaneous use of the PiCSO® system and Impella CP® device during high-risk percutaneous coronary intervention (PCI). This combination offers potential for reduced myocardial damage in select patients undergoing complex PCI.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Devices

Background:

  • ST-segment elevation acute myocardial infarction (STEMI) patients undergoing primary angioplasty with the PiCSO® system show reduced infarct size.
  • Simultaneous use of PiCSO® and Impella CP® in high-risk percutaneous coronary intervention (PCI) has not been previously documented.

Observation:

  • A 76-year-old male with severe, calcified left main coronary disease and impaired left ventricular function underwent high-risk PCI.
  • Coronary artery bypass grafting was not a viable option due to prohibitive surgical risk.

Findings:

  • Successful high-risk PCI was achieved using both PiCSO® and Impella CP® concurrently.
  • The combined use provided mechanical circulatory support and mitigated distal microembolization during the procedure.

Implications:

  • This case demonstrates the feasibility and safety of combining PiCSO® and Impella CP® for simultaneous hemodynamic and microcirculatory support.
  • This approach may reduce post-PCI myocardial damage in carefully selected high-risk PCI patients.
Abstract

Keywords:
Case reportCoronary sinusImpellaLeft mainPCIPiCSO

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