scholarly journals Utilization of extracorporeal membrane oxygenation support for high-risk percutaneous coronary interventions: experience from the Clinical Hospital Dubrava.

2015 ◽  
Vol 10 (9-10) ◽  
pp. 237-237
Author(s):  
Mario Sicaja ◽  
Boris Starcevic
Keyword(s):  
High Risk ◽  
Extracorporeal Membrane Oxygenation ◽  
Percutaneous Coronary Interventions ◽  
Clinical Hospital ◽  
Membrane Oxygenation ◽  
Coronary Interventions ◽  
Percutaneous Coronary

scholarly journals Successful extracorporeal membrane oxygenation assisted revascularisation in a high-risk elderly patient refused surgical treatment

2020 ◽  
Vol 26 (4) ◽  
pp. 205-210
Author(s):  
Robertas Samalavičius ◽  
Lina Puodžiukaitė ◽  
Vytautas Abraitis ◽  
Ieva Norkienė ◽  
Nadežda Ščupakova ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
High Risk ◽  
Elderly Patients ◽  
Extracorporeal Membrane Oxygenation ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Uneventful Recovery ◽  
Membrane Oxygenation ◽  
Percutaneous Coronary

Management of high-risk elderly patients requiring revascularisation remains a clinical challenge. We report a case of extracorporeal membrane oxygenation (ECMO) assisted complex percutaneous coronary intervention in a high-risk octogenarian. An 83-yearold female with signs of worsening heart failure was admitted to the emergency department of a tertiary care facility. Transthoracic echocardiography revealed a decreased left ventricular ejection fraction of 20% with severe mitral regurgitation and mild aortic and tricuspid valve insufficiency. Three-vessel disease was found during coronary angiography. Due to the patient’s frailty, a high-risk surgery decision to proceed with ECMO assisted percutaneous coronary intervention was made during a heart team meeting. Following initiation of mechanical support, coronary lesions were treated with three drug-eluting stents. After the procedure, the patient was transferred to the ICU on ECMO support, where she was successfully weaned from the device 9 h later. Her ICU stay was four days. She was successfully discharged from the hospital after uneventful recovery. At one-year’s follow-up, the patient was clinically stable in an overall state of general well-being and with complete participation in routine activities; she had good exercise tolerance and no signs of ischemia. This report highlights the possibility of use of ECMO during PCI in high-risk elderly patients.

Optimizing rotational atherectomy in high-risk percutaneous coronary interventions: Insights from the PROTECT ΙΙ study

2013 ◽  
Vol 83 (7) ◽  
pp. 1057-1064 ◽  
Author(s):  
Mauricio G. Cohen ◽  
Abhijit Ghatak ◽  
Neal S. Kleiman ◽  
Srihari S. Naidu ◽  
Joseph M. Massaro ◽  
...  
Keyword(s):  
High Risk ◽  
Rotational Atherectomy ◽  
Percutaneous Coronary Interventions ◽  
Coronary Interventions ◽  
Percutaneous Coronary

scholarly journals Access site complications following Impella-supported high-risk percutaneous coronary interventions

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Laura Johannsen ◽  
Amir A. Mahabadi ◽  
Matthias Totzeck ◽  
Andrea Krueger ◽  
Rolf Alexander Jánosi ◽  
...  
Keyword(s):  
High Risk ◽  
Vascular Access ◽  
Academic Research ◽  
Vascular Complications ◽  
Circulatory Support ◽  
Syntax Score ◽  
Percutaneous Coronary Interventions ◽  
Access Site ◽  
Coronary Interventions ◽  
Percutaneous Coronary

AbstractMechanical circulatory support (MCS) devices are increasingly used to provide hemodynamic stability for patients with severe coronary artery disease, comorbidities, and/or impaired hemodynamics during high-risk percutaneous coronary interventions (PCI). Vascular access site complications, particularly those due to the use of large-bore sheaths, may limit outcomes in these patients. The aim of this study was to investigate the incidence and predictors of vascular complications in protected high-risk PCIs. Therefore, we included patients undergoing high-risk PCI with an Impella device from January 2016 to August 2018. Vascular complications were graded according to ‘Valve Academic Research Consortium-2’, a definition routinely used in transcatheter valve implantation procedures. In total, 61 patients (mean age 72 ± 11 years, 79% male, SYNTAX score 33 ± 7) were included, and angiographic- and fluoroscopic-guided vascular access was used for Impella implantation in all patients. Major vascular complications occurred in 5 male patients (8%). All major vascular complications were treated conservatively without the need for surgical intervention, and only one patient received a transfusion of three erythrocyte concentrates. Regression analysis revealed that patients with peripheral arterial disease of the lower extremities are at higher risk of major vascular complications. In conclusion, the utilization of Impella using a standardized protocol for angiographic- and fluoroscopic-guided vascular access was associated with a low rate of vascular complications.

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