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J Am Coll Cardiol. 2015 May 19;65(19):e7-e26. doi: 10.1016/j.jacc.2015.03.036. Epub 2015 Apr 7.

2015 SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care: Endorsed by the American Heart Assocation, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencion; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie d'intervention.

Author information

1
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota. Electronic address: rihal@mayo.edu.
2
Division of Cardiology, Winthrop University Hospital, Mineola, New York.
3
Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts.
4
Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
5
Division of Cardiology, Lehigh Valley Heart Specialists, Allentown, Pennsylvania.
6
Cardiology, Tufts Medical Center, Boston, Massachusetts.
7
Division of Cardiology, UCI Medical Center, Orange, California.
8
Department of Cardiac and Vascular Services, Heart and Vascular Institute of New York, Lenox Hill Hospital, New York, New York.
9
Division of Cardiology, Beaumont Heart Center Clinic, Royal Oak, Michigan.
10
Pediatric Cardiology, UT Southwestern, Dallas, Texas.
11
Louisville Cardiology Group, Interventional Cardiology, Louisville, Kentucky.

Abstract

Although historically the intra-aortic balloon pump has been the only mechanical circulatory support device available to clinicians, a number of new devices have become commercially available and have entered clinical practice. These include axial flow pumps, such as Impella(®); left atrial to femoral artery bypass pumps, specifically the TandemHeart; and new devices for institution of extracorporeal membrane oxygenation. These devices differ significantly in their hemodynamic effects, insertion, monitoring, and clinical applicability. This document reviews the physiologic impact on the circulation of these devices and their use in specific clinical situations. These situations include patients undergoing high-risk percutaneous coronary intervention, those presenting with cardiogenic shock, and acute decompensated heart failure. Specialized uses for right-sided support and in pediatric populations are discussed and the clinical utility of mechanical circulatory support devices is reviewed, as are the American College of Cardiology/American Heart Association clinical practice guidelines.

KEYWORDS:

ACC Expert Consensus Document; cardiogenic; percutaneous coronary intervention; shock; ventricular assist device

PMID:
25861963
DOI:
10.1016/j.jacc.2015.03.036
[Indexed for MEDLINE]
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