Cardiac intensive care management of high-risk percutaneous coronary intervention using the venoarterial ECMO support

AbstractThe emerging concept of high-risk percutaneous coronary intervention (HR-PCI) has required the adoption of a multidisciplinary team approach. Venoarterial ECMO (VA-ECMO) has been introduced as a temporary mechanical circulatory support (MCS) for HR-PCI patients in order to provide an adequate systemic perfusion during the procedure. Both patient ’s complexity and technological evolutions have catalyzed the development of critical care cardiology; however, ECMO therapy faces several challenges. Indeed, the management of patients on ECMO remains complex; moreover, the lack of specific recommendation for HR-PCI patients further complicates t he management of these patients. In this narrative review, we give a reappraisal for the management of HR-PCI patients supported with VA-ECMO according to the available data published in current literature.
Source: Heart Failure Reviews - Category: Cardiology Source Type: research

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Microvascular obstruction is a common repercussion of percutaneous coronary intervention for distal microembolization, ischemia –reperfusion injury and inflammation, which increases post-myocardial infarction heart failure and mortality. Ultrasound-targeted microbubble cavitation (UTMC) may resolve microvascular obstruction while activating endothelial nitric oxide synthase (eNOS) and increasing endothelium-derived nitric oxide (NO) bioavailability. Nitrite, a cardioprotective agent, offers an additional source of NO and potential synergy with UTMC.
Source: Ultrasound in Medicine and Biology - Category: Radiology Authors: Tags: Original Contribution Source Type: research
CONCLUSION: Acute myocardial infarction and hypertrophic cardiomyopathy patients who were obese exhibited worse long-term outcomes than those without obesity. PMID: 31674878 [PubMed - as supplied by publisher]
Source: Perfusion - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Perfusion Source Type: research
AbstractBackgroundThe amelioration of myocardial reperfusion in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PPCI) remains a significant issue.ObjectiveWe conducted a meta-analysis of randomized controlled trials (RCTs) to better assess the effects of intracoronary nicorandil administration on myocardial microcirculation and clinical outcomes in these patients.MethodsThe meta-analysis was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. A literature search was performed in the PubMed, Embase, Cochrane ...
Source: American Journal of Cardiovascular Drugs - Category: Cardiology Source Type: research
AbstractClinical predictors for later adverse cardiovascular events in patients undergoing percutaneous coronary intervention (PCI) for silent myocardial ischemia remain undetermined. We investigated clinical features leading to later adverse cardiovascular events in patients who underwent PCI for silent myocardial ischemia. Of a total of 294 consecutive patients with a diagnosis of silent myocardial ischemia who successfully underwent contemporary PCI in our institute between January 2013 and December 2014, an initial event of any of all-cause death, hospitalized heart failure, acute coronary syndromes, and target vessel ...
Source: Heart and Vessels - Category: Cardiology Source Type: research
Giuseppe Ristagno1*, Francesca Fumagalli1, Barbara Bottazzi2, Alberto Mantovani2,3,4, Davide Olivari1, Deborah Novelli1 and Roberto Latini1 1Department of Cardiovascular Research, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy 2Humanitas Clinical and Research Center-IRCCS, Milan, Italy 3Humanitas University, Milan, Italy 4The William Harvey Research Institute, Queen Mary University of London, London, United Kingdom The long pentraxin PTX3 is a member of the pentraxin family produced locally by stromal and myeloid cells in response to proinflammatory signals and microbial moieties. The p...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
ConclusionsThe simulation illustrates how temporary circulatory support with an Impella microaxial pump can stabilize haemodynamics and allow for a safe procedure in an unstable patient. Using computer simulation of haemodynamics to understand changes in haemodynamics when performing interventions in unstable patients might help to properly select a suitable support device if needed.
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Perspective Source Type: research
AbstractClinical impact of tissue protrusion (TP) after coronary stenting is still controversial, especially in patients with ST-segment elevation myocardial infarction (STEMI). A total of 104 STEMI patients without previous MI who underwent primary percutaneous coronary intervention (PCI) under intravascular ultrasound (IVUS)-guidance were included. Post-stenting grayscale IVUS analysis was performed, and the patients were classified according to the presence or absence of post-stenting TP on IVUS. Coronary angiography and single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI) with99mTc tetrof...
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research
We report on a 73-year-old woman who presented with heart failure secondary to graft stenosis of the right coronary artery 6 months after undergoing a modified Bentall procedure. Percutaneous coronary intervention (PCI) was performed and type II coronary artery perforation occurred during PCI of the right coronary artery. We used a perfusion balloon and achieved hemostasis successfully. We report a case of coronary artery perforation that was treated with perfusion balloon during PCI in a patient with a prior modified Bentall procedure. In addition, we present a case series of PCI for ostial coronary stenosis after the Ben...
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
Authors: Ottani F, Limbruno U, Latini R, Misuraca L, Galvani M Abstract Ischemic heart disease remains a leading cause of death worldwide, responsible for an estimated 17.5 million deaths in 2012. Mortality from St-elevation myocardial infarction STEMI have decreased over the last 3 decades. However, despite the success of reperfusion therapy by primary percutaneous coronary intervention (PPCI) or thrombolysis, STEMI is still of significant concern. A recent patient-level meta-analysis emphasized the pivotal importance of infarct size within 1 month after PPCI as a determinant of all-cause mortality and hospitaliza...
Source: Minerva Cardioangiologica - Category: Cardiology Tags: Minerva Cardioangiol Source Type: research
Time limit: 0 Quiz-summary 0 of 20 questions completed Questions: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Information This test series requires login for attempting. You can login easily with your Facebook account (Use the CONNECT WITH icon on the upper part of right sidebar displaying t...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology Source Type: blogs
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