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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Published on: June 12, 2021

Clinical Impact of Complete Revascularization Before Left Ventricular Assist Device Implantation in Patients With

David Hong1, Ah-Ram Kim2, Minjung Bak3

  • 1Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

Artificial Organs
|August 13, 2026
PubMed

Insights

Complete revascularization (CR) by percutaneous coronary intervention (PCI) before left ventricular assist device (LVAD) implantation did not improve outcomes in severe ischemic cardiomyopathy patients. Careful case-by-case consideration of PCI before LVAD is advised.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Interventional Cardiology

Background:

  • Limited data exists on the impact of percutaneous coronary intervention (PCI) before left ventricular assist device (LVAD) implantation.
  • Severe ischemic cardiomyopathy (ICM) patients often require advanced therapies like LVADs.
  • The role of complete revascularization (CR) via PCI in this population remains unclear.

Purpose of the Study:

  • To investigate the clinical impact of CR by PCI prior to LVAD implantation in patients with severe ICM.
  • To assess whether pre-LVAD PCI improves outcomes in patients with ICM.

Main Methods:

  • Retrospective analysis of 118 ICM patients undergoing LVAD implantation at two tertiary centers.
  • Patients were divided into CR by PCI group and incomplete revascularization group.
  • Primary outcome was 2-year all-cause mortality; secondary outcomes included heart failure hospitalizations, arrhythmias, and transplant rates.

Main Results:

  • 35.6% of patients achieved CR by PCI before LVAD implantation.
  • No significant difference in 2-year all-cause mortality between CR (18.3%) and incomplete revascularization (22.8%) groups (HR 0.76, p=0.554).
  • No significant differences observed in heart failure hospitalizations, arrhythmias, RV failure, or heart transplantation rates.

Conclusions:

  • Complete revascularization by PCI before LVAD implantation does not improve clinical outcomes in severe ICM patients.
  • Revascularization decisions prior to LVAD should be individualized, balancing potential risks and benefits.
  • Further research may be needed to identify specific patient subgroups who might benefit from pre-LVAD PCI.
Abstract

Keywords:
cardiomyopathiesheart‐assist devicesmyocardial revascularization

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