在高危经皮冠状动脉介入治疗期间使用 CardioHELP 装置进行临时血液动力学支持。

Use of the CardioHELP Device for Temporary Hemodynamic Support During High-Risk Percutaneous Coronary Intervention.

机构信息

MemorialCare Heart and Vascular Institute, Long Beach Memorial Medical Center, 2801 Atlantic Ave, Long Beach, CA 90033 USA.

出版信息

J Invasive Cardiol. 2021 Aug;33(8):E614-E618. doi: 10.25270/jic/20.00652.

DOI:10.25270/jic/20.00652

PMID:34338652

Abstract

BACKGROUND

Temporary extracorporeal membrane oxygenation (ECMO) support for high-risk percutaneous coronary intervention (PCI) has been described in select patients, and data are limited on the CardioHELP device (Maquet). The objective of this study was to assess clinical outcomes in patients undergoing elective, high-risk PCI with CardioHELP support.

METHODS

Fifteen consecutive patients receiving the CardioHELP device for elective, high-risk PCI treated at 2 medical centers were included. Patients with cardiogenic shock, cardiac arrest, or non-PCI indications for ECMO were excluded. Baseline demographics, angiographic variables, procedure-related variables, and in-hospital events were collected.

RESULTS

Mean age was 71 ± 11 years, 73% were male, mean ejection fraction (EF) was 29 ± 13%, 10 patients (67%) had an EF <30%, and mean SYNTAX I score was 32 ± 11. Multivessel coronary artery disease was present in 14 patients (93%) and unprotected left main coronary artery disease was present in 4 patients (27%). PCI was successful in all patients. In-hospital mortality occurred in 3 patients (20%), 7 patients (47%) received a blood transfusion, and there were no major vascular complications.

CONCLUSION

Temporary use of the CardioHELP device for high-risk PCI is associated with acceptable short-term outcome and may be a new option for patients with complex coronary artery disease and left ventricular dysfunction.

摘要

背景

在某些患者中，已描述了用于高危经皮冠状动脉介入治疗（PCI）的临时体外膜肺氧合（ECMO）支持，但是关于 CardioHELP 设备（Maquet）的数据有限。本研究的目的是评估接受选择性高危 PCI 的患者使用 CardioHELP 支持的临床结局。

方法

在 2 家医疗中心中，对接受 CardioHELP 设备治疗的 15 例连续接受选择性高危 PCI 的患者进行了研究。排除因心源性休克、心脏骤停或 ECMO 的非 PCI 适应证而接受治疗的患者。收集了基线人口统计学、血管造影变量、与手术相关的变量以及住院期间的事件。

结果

平均年龄为 71 ± 11 岁，73%为男性，平均射血分数（EF）为 29 ± 13%，10 例（67%）患者的 EF <30%，平均 SYNTAX I 评分 32 ± 11。14 例（93%）患者存在多支冠状动脉疾病，4 例（27%）患者存在无保护的左主干冠状动脉疾病。所有患者的 PCI 均获得成功。住院期间有 3 例（20%）患者死亡，7 例（47%）患者接受了输血，并且没有发生主要血管并发症。