Types of Hemodynamic Support in the Cath Lab.

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Presentation transcript:

Types of Hemodynamic Support in the Cath Lab

Hemodynamic Support Devices for the Cath Lab

Indications for Cath Lab Hemodynamic Support Cath Lab hemodynamic support Elective high- risk PCI PCI in Cardiogenic shock Impaired LV function PCI to a single last patent conduit PCI of vessel(s) supplying a large myocardial territory Recent high-risk ACS Heterogeneous Non-atherosclerotic CAD Underlying LV impairment, scar, valvular disease or dysrhythmia

SCHEMATIC REPRESENTATION OF ECMO

SCHEMATIC REPRESENTATION OF IABP

SCHEMATIC REPRESENTATION OF IMPELLA

Evidence for IMPELLA system

PROTECT II Trial Design

Procedural Characteristics

LVEF and NYHA Improvement Post PCI

PROTECT II: Per Protocol MAE (N=427)

PROTECT II MAE Outcome Pre-specified High Risk PCI Without Atherectomy Group Per Protocol (N=374)

USPELLA Registry: Impella® Insertion Timing (N= 154) O’Neill et al, J Interven Cardiol 2013;9999:1-11

Outcome: Impella Pre or Post PCI

Outcome By Support Strategy Survival to discharge

Conclusions Impella & IABP are most frequently used hemodynamic support devices in the cath lab that facilitate performance of high-risk elective PCI & during cardiogenic shock Impella provides better balance of efficacy, safety & feasibility during high risk PCI & provides superior hemodynamic support compared to IABP, especially if placed pre- PCI

A LOOK BEYOND: THE AORTIX DEVICE

A BEYOND LOOK: AORTIX REPRESENTATION