Zein Rami, Patel Chirdeep, Mercado-Alamo Adrian, Schreiber Theodore, Kaki Amir
Interventional Cardiology Department, Ascension St John Hospital and Medical Center Detroit, MI, US.
Interv Cardiol. 2022 Apr 8;17:e05. doi: 10.15420/icr.2021.11. eCollection 2022 Jan.
The use of mechanical circulatory support (MCS) to provide acute haemodynamic support for cardiogenic shock or to support high-risk percutaneous coronary intervention (HRPCI) has grown over the past decade. There is currently no consensus on best practice regarding its use in these two distinct indications. Impella heart pumps (Abiomed) are intravascular microaxial blood pumps that provide temporary MCS during HRPCI or in the treatment of cardiogenic shock. The authors outline technical specifications of the individual Impella heart pumps and their accompanying technology, the Automated Impella Controller and SmartAssist, their indications for use and patient selection, implantation techniques, device weaning and escalation, closure strategies, anticoagulation regimens, complications, future directions and upcoming trials.
在过去十年中,使用机械循环支持(MCS)为心源性休克提供急性血流动力学支持或支持高危经皮冠状动脉介入治疗(HRPCI)的情况有所增加。目前,对于其在这两种不同适应症中的最佳使用方法尚无共识。Impella心脏泵(Abiomed公司)是血管内微轴血泵,在HRPCI期间或治疗心源性休克时提供临时MCS。作者概述了各个Impella心脏泵及其配套技术(自动Impella控制器和智能辅助系统)的技术规格、使用适应症和患者选择、植入技术、设备撤离和升级、闭合策略、抗凝方案、并发症、未来方向以及即将开展的试验。