IMR Press / RCM / Volume 14 / Issue 2-4 / DOI: 10.3909/ricm0675
Open Access Case Review
The Use of Percutaneous Left Ventricular Assist Device in High-risk Percutaneous Coronary Intervention and Cardiogenic Shock
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1 Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA
Rev. Cardiovasc. Med. 2013 , 14(2-4), 144–149; https://doi.org/10.3909/ricm0675
Published: 30 June 2013
Abstract
Patients with high-risk coronary lesions may be denied coronary artery bypass grafting due to excessive comorbidities. Percutaneous coronary intervention (PCI) may be a feasible revascularization strategy in high-risk patients who present with ST-elevation myocardial infarction and cardiogenic shock. Historically, the use if intra-aortic balloon pump (IABP) has been used in high-risk PCI and cardiogenic shock. However, recent data has shown that elective IABP insertion did not reduce the incidence of major cardiovascular events following PCI. The use of a left ventricular assist device is a reasonable and safe alternative compared with IABP counterpulsation, giving greater cardiac output and hemodynamic support in patients undergoing high-risk PCI and in those with severe cardiogenic shock. This review outlines a case of severe cardiogenic shock and hemodynamic instability where high-risk PCI is a reasonable option.
Keywords
Percutaneous coronary intervention
Left ventricular assist device
Cardiogenic shock
Intra-aortic balloon pump
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