The following resources and case studies are provided to High Risk PCI registrants by Abiomed. Case studies are provided as a courtesy to further knowledge of available support devices and therapies. Resources on this page are not approved by SCAI for CME credit, and SCAI does not validate or endorse educational content or information contained within these resources.
Alex Y. Tan, MD, Jeffrey J. Popma, MD, David Leeman, MD
The Cardiovascular Institute at the Beth Israel Deaconess
Medical Center, Boston, Massachusetts and Harvard Medical School, Boston, Massachusetts
A case involving a 61-year-old man who presented with profound cardiogenic shock secondary to a non-ischemic cardiomyopathy. The use of temporary percutaneous left ventricular support with the Abiomed Impella 2.5 circulatory support device restored acceptable hemodynamics, improved cardiac output, reduced left ventricular wall tension, and improved myocardial perfusion, allowing left ventricular recovery over the ensuing 72-96 hours.
Mark A Grise, MD, Tyrone J. Collins, MD, and Samir N. Patel, MD
Ochsner Heart and Vascular Institute
New Orleans, LA
A case involving a 77 year-old obese female with diabetes mellitus, hypertension, and dyslipidemia initially presented in the catheterization laboratory with signs of acute systolic heart failure. After stabilizing the patient, the decision was made to proceed with a percutaneous coronary intervention (PCI) supported with the Impella Recover LP 2.5 Percutaneous Cardiac Support System.
Amid Khan, MD, Eric Gnall, DO, Timothy Shapiro, MD
Patients with compromised left ventricular (LV) function benefit from LV unloading during high-risk percutaneous coronary intervention (PCI). The Impella 2.5 (Impella, Figure 1) is a minimally invasive, catheter-based cardiac assist device designed to directly unload the LV and thereby reduce myocardial work and oxygen consumption. The device augments cardiac output and improves coronary and systemic end-organ perfusion. We report on a patient with severe LV impairment who underwent a complex PCI while supported with the Impella, and had an uneventful recovery and hospital discharge.
Igor Palacios, MD, Roberto J. Cubeddu, MD, Christian Witzke, MD, Angel Caldera, MD
Massachusetts General Hospital
Summary A 55-year old woman with a history of heavy alcohol abuse, hepatitis C induced cirrhosis, hypertension, and chronic renal insufficiency presented at Massachusetts General Hospital in Boston, MA with nine months of increasing intermittent substernal chest pressure. The pain was inducible by exertion, was nonradiating, and when present associated with shortness of breath and diaphoresis.
Neeraj Badhey, MD, Subhash Banerjee, MD, Emmanouil S. Brilakis, MD, PhD
VA North Texas Healthcare System and University of Texas Southwestern Medical School
A 64-year-old man was admitted with unstable angina and severe congestive heart failure (CHF) three months after what was considered an uncomplicated coronary artery bypass graft (CABG) revascularization.
Left Ventricular assist devices help in reducing the cardiac workload and provide circulatory assistance and protection to the myocardium and vital organs in patients with severe systolic dysfunction. Impella, a percutaneous left ventricular assist device is increasingly being used for circulatory support in patients with high risk percutaneous coronary interventions (PCI). Severe peripheral vascular disease is a relative contraindication for Impella placement. Presence of vessel tortuosity, calcification, stents and stent-grafts in the aortoiliac vasculature may hinder insertion of Impella. However, we have found that we have been able to implant Impella in over 135 patients with relative ease. Some of these patients presented with PAD, but we were able to navigate through the vessels for successful implantation.
This webcast discusses new findings from PROTECT II, including insights from industry leaders William O’Neill, M.D., Jeffrey Popma, M.D., John Lasala, M.D., and Jeffrey Moses, M.D. The video includes analysis of the PROTECT II results, how it compares to previous studies, new findings around the effects of extensive revascularization and Impella’s cost-effectiveness for the high risk PCI patient population.