Percutaneous Mechanical Circulatory Support Devices

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Presentation transcript:

Percutaneous Mechanical Circulatory Support Devices

57-year-old man presents with an anterior STEMI PCI to LAD undertaken -- unable to reopen vessel despite prolonged attempt Persisting ST elevation at the end of case BP 110/60 mm Hg Transferred to CCU at 6 pm Clinical deterioration by the following morning Oliguric Diaphoretic Cool peripheries Lactate 4 Persisting ST elevation BP 120/80 mm Hg ECHO -- poor EF -- 10% Transferred to cath lab for hemodynamic support in view of (incipient) cardiogenic shock

Stabilization After IAPM Implantation

Pulmonary Artery Pressure

OUTCOME

Case Key Points

Hemodynamic Effects of IABP

Options for Mechanical Cardiopulmonary Support

2013 ACCF/AHA Guideline for the Management of STEMI

Cost-Effectiveness

Possible Indications for Mechanical Circulatory Support Devices

Balancing the Issue of Cost Selecting the Right Device for the Right Patient

Hemodynamic Support for the Cardiac Arrest Survivor

Impella®

Vasopressors vs Support Devices

ECMO

TandemHeart™

MCS for High-Risk PCI

Summary

Abbreviations

Abbreviations (cont)

Abbreviations (cont)

References

References (cont)