Percutaneous LVAD an Alternative in High-risk PCI
Preclosing the femoral artery before device insertion may significantly reduce the risk of post-PCI complications.
Patients with high-risk coronary artery lesions, who have an increased risk for complications during percutaneous coronary intervention (PCI), may benefit from the inclusion of a TandemHeart (CardiacAssist, Pittsburgh) during the procedure.
TandemHeart
The TandemHeart is a percutaneous left ventricular assist device (LVAD). Researchers led by Annapoorna S. Kini, MD, from Mt. Sinai Medical Center, New York, effectively employed the device for circulatory support during high-risk PCI in 20 patients.
All patients had moderate-to-severe left ventricle dysfunction. Five patients underwent left main coronary artery stenting, and three underwent rotational atherectomy.
The rates for both procedural and clinical success were 100%.
The average total procedure time was 100 minutes, and mean insertion time was 32 minutes; 2.5 to 3.0 L/min of circulatory support was used during PCI.
The rate of complications was “extremely low,” according to the study. One patient experienced a moderate-sized groin hematoma, with no complications occurring in any of the remaining patients.
Importantly, surgeons preclosed the femoral artery. Doing so before inserting the percutaneous LVAD can significantly reduce the incidence of complications, they noted.
The device was easily deployed and removed in all patients, and the average length of stay was two days.
The average age of patients was 68 years, and 14 were men.