The role of Impella in high-risk percutaneous coronary intervention.

Percutaneous coronary intervention (PCI) has been increasingly performed in patients with severely depressed left ventricular function and complex coronary lesions, including multivessel disease. Mechanical ventricular assist devices play an increasingly important role in high-risk PCI. Impella CP (Abiomed, Inc.) is a new percutaneous left ventricular assist device, designed for short-term circulatory support. It is a promising option for hemodynamic support in high-risk procedures and can potentially reduce PCI-related complications. The authors present two case reports of high-risk PCI using the Impella CP device. In the setting of low coronary flow reserve, severely depressed left ventricular function and potential hemodynamic instability, the Impella CP device has made it possible to maintain hemodynamic stability during procedures, without being associated with vascular complications.