Percutaneous mechanical circulatory support devices, including Impella, TandemHeart, and ECMO, are reviewed for their physiologic impact and clinical utility in various cardiovascular conditions.
Provides a clinical expert consensus on the physiologic impact and clinical utility of various percutaneous mechanical circulatory support devices across different cardiovascular scenarios.
Although historically the intra-aortic balloon pump has been the only mechanical circulatory support device available to clinicians, a number of new devices have become commercially available and have entered clinical practice. These include axial flow pumps, such as Impella®; left atrial to femoral artery bypass pumps, specifically the TandemHeart; and new devices for institution of extracorporeal membrane oxygenation. These devices differ significantly in their hemodynamic effects, insertion, monitoring, and clinical applicability. This document reviews the physiologic impact on the circulation of these devices and their use in specific clinical situations. These situations include patients undergoing high-risk percutaneous coronary intervention, those presenting with cardiogenic shock, and acute decompensated heart failure. Specialized uses for right-sided support and in pediatric populations are discussed and the clinical utility of mechanical circulatory support devices is reviewed, as are the American College of Cardiology/American Heart Association clinical practice guidelines.
Rihal et al. (Tue,) conducted a review in Cardiovascular care (high-risk PCI, cardiogenic shock, acute decompensated heart failure). Percutaneous mechanical circulatory support devices was evaluated. Percutaneous mechanical circulatory support devices, including Impella, TandemHeart, and ECMO, are reviewed for their physiologic impact and clinical utility in various cardiovascular conditions.
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