Why the study?
Does mechanical circulatory support improve outcomes in high-risk patients with severely reduced left ventricular systolic function undergoing complex percutaneous coronary intervention?
Does mechanical circulatory support improve outcomes in high-risk patients with severely reduced left ventricular systolic function undergoing complex percutaneous coronary intervention?
Observational data currently support the use of mechanical circulatory support for complex high-risk PCI in patients with severe LV dysfunction, though definitive guidance awaits ongoing randomized trials.
Supports heart team evaluation for MCS in select high-risk PCI; leaves definitive outcome benefit open pending RCTs.
Technological and procedural innovations presently permit the safe and effective performance of increasingly complex percutaneous coronary interventions, while new mechanical circulatory support devices offer circulatory and ventricular support to patients with severely reduced left ventricular systolic function and deranged cardiovascular hemodynamics. Together, these advances now permit the application of complex percutaneous coronary interventions to higher-risk patients who might otherwise be left untreated. Increasing observational data support the use of mechanical circulatory support in appropriate complex and high-risk patients as part of a larger multidisciplinary heart team treatment plan. In-progress and upcoming randomized clinical trials may provide higher-quality evidence to better guide management decisions in the near future.
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Truesdell et al. (2023) studied this question.
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