Single-center experience with the TandemHeart percutaneous ventricular assist device to support patients undergoing high-risk percutaneous coronary intervention

Wael Al-Husami, Frederick Yturralde, Guru Mohanty, Christopher Pastore, Kapildeo Lotun, David Venesy, Sergio Waxman, Christopher Pyne, David Gossman, Richard Nesto, Thomas Piemonte

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

We describe our experience of patients, from December 2005 through May 2007 who underwent percutaneous coronary intervention (PCI) with severely depressed left ventricle systolic function and complex coronary lesions. The complex coronary lesions included multiple vessel coronary artery disease, left main (LM) coronary artery disease, calcified coronary lesions and bypass graft disease. All patients were clinically assessed to be at too high of a risk for circulatory collapse without maximal hemodynamic support while they underwent high-risk PCI. The TandemHeart percutaneous ventricular assist device (THpVAD) may be able to provide the necessary circulatory support required to enhance procedural success and patient safety during high-risk PCI. METHODS AND RESULTS: We implanted the THpVAD in 6 patients who underwent high-risk PCI. There was unanimity among several physicians in our institution that each patient was an exceptionally high risk for circulatory collapse due to the anticipated procedural complexity. The average ejection fraction was 33% (range 15-65%). Five of the patients were considered to be at an unacceptably high risk for coronary artery bypass surgery. All 6 patients underwent multivessel PCI. Five of the 6 underwent unprotected LM PCI. One patient of the 5 underwent vein-graft PCI as well as a debulking procedure with rotational atherectomy and PCI of the LM. We had a 100% success rate with implantation of the THpVAD. Five of the 6 patients were alive at 30 days post procedure. One patient died 3 days after the procedure due to multiorgan failure. A vascular surgeon performed the removal of the devices with no associated complications. CONCLUSIONS: Our clinical experiences with the TandemHeart pVAD demonstrated that hemodynamic support could be achieved safely, efficiently and effectively by way of a percutaneous route in anticipation of high-risk PCI.

Original languageEnglish (US)
Pages (from-to)319-322
Number of pages4
JournalJournal of Invasive Cardiology
Volume20
Issue number6
StatePublished - Jun 2008
Externally publishedYes

Fingerprint

Heart-Assist Devices
Percutaneous Coronary Intervention
Coronary Artery Disease
Shock
Hemodynamics
Coronary Atherectomy
Device Removal
Transplants
Patient Safety
Coronary Artery Bypass
Heart Ventricles
Blood Vessels
Veins
Physicians

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Single-center experience with the TandemHeart percutaneous ventricular assist device to support patients undergoing high-risk percutaneous coronary intervention. / Al-Husami, Wael; Yturralde, Frederick; Mohanty, Guru; Pastore, Christopher; Lotun, Kapildeo; Venesy, David; Waxman, Sergio; Pyne, Christopher; Gossman, David; Nesto, Richard; Piemonte, Thomas.

In: Journal of Invasive Cardiology, Vol. 20, No. 6, 06.2008, p. 319-322.

Research output: Contribution to journalArticle

Al-Husami, W, Yturralde, F, Mohanty, G, Pastore, C, Lotun, K, Venesy, D, Waxman, S, Pyne, C, Gossman, D, Nesto, R & Piemonte, T 2008, 'Single-center experience with the TandemHeart percutaneous ventricular assist device to support patients undergoing high-risk percutaneous coronary intervention', Journal of Invasive Cardiology, vol. 20, no. 6, pp. 319-322.
Al-Husami, Wael ; Yturralde, Frederick ; Mohanty, Guru ; Pastore, Christopher ; Lotun, Kapildeo ; Venesy, David ; Waxman, Sergio ; Pyne, Christopher ; Gossman, David ; Nesto, Richard ; Piemonte, Thomas. / Single-center experience with the TandemHeart percutaneous ventricular assist device to support patients undergoing high-risk percutaneous coronary intervention. In: Journal of Invasive Cardiology. 2008 ; Vol. 20, No. 6. pp. 319-322.
@article{52bb7d5300a145dbb3fff08b2158fba0,
title = "Single-center experience with the TandemHeart percutaneous ventricular assist device to support patients undergoing high-risk percutaneous coronary intervention",
abstract = "We describe our experience of patients, from December 2005 through May 2007 who underwent percutaneous coronary intervention (PCI) with severely depressed left ventricle systolic function and complex coronary lesions. The complex coronary lesions included multiple vessel coronary artery disease, left main (LM) coronary artery disease, calcified coronary lesions and bypass graft disease. All patients were clinically assessed to be at too high of a risk for circulatory collapse without maximal hemodynamic support while they underwent high-risk PCI. The TandemHeart percutaneous ventricular assist device (THpVAD) may be able to provide the necessary circulatory support required to enhance procedural success and patient safety during high-risk PCI. METHODS AND RESULTS: We implanted the THpVAD in 6 patients who underwent high-risk PCI. There was unanimity among several physicians in our institution that each patient was an exceptionally high risk for circulatory collapse due to the anticipated procedural complexity. The average ejection fraction was 33{\%} (range 15-65{\%}). Five of the patients were considered to be at an unacceptably high risk for coronary artery bypass surgery. All 6 patients underwent multivessel PCI. Five of the 6 underwent unprotected LM PCI. One patient of the 5 underwent vein-graft PCI as well as a debulking procedure with rotational atherectomy and PCI of the LM. We had a 100{\%} success rate with implantation of the THpVAD. Five of the 6 patients were alive at 30 days post procedure. One patient died 3 days after the procedure due to multiorgan failure. A vascular surgeon performed the removal of the devices with no associated complications. CONCLUSIONS: Our clinical experiences with the TandemHeart pVAD demonstrated that hemodynamic support could be achieved safely, efficiently and effectively by way of a percutaneous route in anticipation of high-risk PCI.",
author = "Wael Al-Husami and Frederick Yturralde and Guru Mohanty and Christopher Pastore and Kapildeo Lotun and David Venesy and Sergio Waxman and Christopher Pyne and David Gossman and Richard Nesto and Thomas Piemonte",
year = "2008",
month = "6",
language = "English (US)",
volume = "20",
pages = "319--322",
journal = "Journal of Invasive Cardiology",
issn = "1042-3931",
publisher = "HMP Communications",
number = "6",

}

TY - JOUR

T1 - Single-center experience with the TandemHeart percutaneous ventricular assist device to support patients undergoing high-risk percutaneous coronary intervention

AU - Al-Husami, Wael

AU - Yturralde, Frederick

AU - Mohanty, Guru

AU - Pastore, Christopher

AU - Lotun, Kapildeo

AU - Venesy, David

AU - Waxman, Sergio

AU - Pyne, Christopher

AU - Gossman, David

AU - Nesto, Richard

AU - Piemonte, Thomas

PY - 2008/6

Y1 - 2008/6

N2 - We describe our experience of patients, from December 2005 through May 2007 who underwent percutaneous coronary intervention (PCI) with severely depressed left ventricle systolic function and complex coronary lesions. The complex coronary lesions included multiple vessel coronary artery disease, left main (LM) coronary artery disease, calcified coronary lesions and bypass graft disease. All patients were clinically assessed to be at too high of a risk for circulatory collapse without maximal hemodynamic support while they underwent high-risk PCI. The TandemHeart percutaneous ventricular assist device (THpVAD) may be able to provide the necessary circulatory support required to enhance procedural success and patient safety during high-risk PCI. METHODS AND RESULTS: We implanted the THpVAD in 6 patients who underwent high-risk PCI. There was unanimity among several physicians in our institution that each patient was an exceptionally high risk for circulatory collapse due to the anticipated procedural complexity. The average ejection fraction was 33% (range 15-65%). Five of the patients were considered to be at an unacceptably high risk for coronary artery bypass surgery. All 6 patients underwent multivessel PCI. Five of the 6 underwent unprotected LM PCI. One patient of the 5 underwent vein-graft PCI as well as a debulking procedure with rotational atherectomy and PCI of the LM. We had a 100% success rate with implantation of the THpVAD. Five of the 6 patients were alive at 30 days post procedure. One patient died 3 days after the procedure due to multiorgan failure. A vascular surgeon performed the removal of the devices with no associated complications. CONCLUSIONS: Our clinical experiences with the TandemHeart pVAD demonstrated that hemodynamic support could be achieved safely, efficiently and effectively by way of a percutaneous route in anticipation of high-risk PCI.

AB - We describe our experience of patients, from December 2005 through May 2007 who underwent percutaneous coronary intervention (PCI) with severely depressed left ventricle systolic function and complex coronary lesions. The complex coronary lesions included multiple vessel coronary artery disease, left main (LM) coronary artery disease, calcified coronary lesions and bypass graft disease. All patients were clinically assessed to be at too high of a risk for circulatory collapse without maximal hemodynamic support while they underwent high-risk PCI. The TandemHeart percutaneous ventricular assist device (THpVAD) may be able to provide the necessary circulatory support required to enhance procedural success and patient safety during high-risk PCI. METHODS AND RESULTS: We implanted the THpVAD in 6 patients who underwent high-risk PCI. There was unanimity among several physicians in our institution that each patient was an exceptionally high risk for circulatory collapse due to the anticipated procedural complexity. The average ejection fraction was 33% (range 15-65%). Five of the patients were considered to be at an unacceptably high risk for coronary artery bypass surgery. All 6 patients underwent multivessel PCI. Five of the 6 underwent unprotected LM PCI. One patient of the 5 underwent vein-graft PCI as well as a debulking procedure with rotational atherectomy and PCI of the LM. We had a 100% success rate with implantation of the THpVAD. Five of the 6 patients were alive at 30 days post procedure. One patient died 3 days after the procedure due to multiorgan failure. A vascular surgeon performed the removal of the devices with no associated complications. CONCLUSIONS: Our clinical experiences with the TandemHeart pVAD demonstrated that hemodynamic support could be achieved safely, efficiently and effectively by way of a percutaneous route in anticipation of high-risk PCI.

UR - http://www.scopus.com/inward/record.url?scp=46749156423&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=46749156423&partnerID=8YFLogxK

M3 - Article

C2 - 18523330

AN - SCOPUS:46749156423

VL - 20

SP - 319

EP - 322

JO - Journal of Invasive Cardiology

JF - Journal of Invasive Cardiology

SN - 1042-3931

IS - 6

ER -