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Review Case Reports
The use of percutaneous left ventricular assist device in high-risk percutaneous coronary intervention and cardiogenic shock.
- Andre Babak Akhondi and Michael S Lee.
- Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA.
- Rev Cardiovasc Med. 2013 Jan 1;14(2-4):e144-9.
AbstractPatients with high-risk coronary lesions may be denied coronary artery bypass grafting due to excessive comorbidities. Percutaneous coronary intervention (PCI) may be a feasible revascularization strategy in high-risk patients who present with ST-elevation myocardial infarction and cardiogenic shock. Historically, the use if intra-aortic balloon pump (IABP) has been used in high-risk PCI and cardiogenic shock. However, recent data has shown that elective IABP insertion did not reduce the incidence of major cardiovascular events following PCI. The use of a left ventricular assist device is a reasonable and safe alternative compared with IABP counterpulsation, giving greater cardiac output and hemodynamic support in patients undergoing high-risk PCI and in those with severe cardiogenic shock. This review outlines a case of severe cardiogenic shock and hemodynamic instability where high-risk PCI is a reasonable option.
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