eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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3/2016
vol. 12
 
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Circulatory support with Impella CP device during high-risk percutaneous coronary interventions: initial experience in Poland

Dariusz Dudek
,
Tomasz Rakowski
,
Adam Sukiennik
,
Michał Hawranek
,
Artur Dziewierz
,
Jacek Kubica
,
Piotr Suwalski
,
Robert Gil
,
Wojciech Wojakowski
,
Andrzej Ochała
,
Wiesław Mazurek
,
Krzysztof Żmudka
,
Mariusz Gąsior

Adv Interv Cardiol 2016; 12, 3 (45): 254–257
DOI: https://doi.org/10.5114/aic.2016.61648
Online publish date: 2016/08/19
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Introduction

Coronary revascularization is an important part of the treatment of patients with coronary artery disease. However, a significant proportion of patients are characterized by high-risk features. Many of these patients are referred for high-risk percutaneous coronary interventions (PCIs) due to the extremely high risk of surgery. To support such procedures and to facilitate the care of high-risk patients, percutaneous left ventricular assist devices (pLVAD) were developed. Due to confounding data and downgraded guidelines for use of the intra-aortic balloon pump (IABP), especially in cardiogenic shock caused by myocardial infarction (MI), there is currently growing interest in pLVAD [1, 2]. The use of pLVAD during high-risk PCI in Europe varies from country to country mainly due to different reimbursement policies.

Aim

Due to growing interest in pLVAD support during high-risk PCIs in Poland and Europe, we aim to present our initial experience with the Impella CP system during high-risk PCIs.

Material and methods

The study is a prospective registry of all patients treated with the Impella CP (ABIOMED Inc., Danvers, MA, USA) in Poland. Data are collected based on a dedicated questionnaire. The registry is currently conducted in six high-volume PCI centers. All procedures are performed with highly experienced operators and are fully supported by company (distributor in Poland) staff either on site for elective procedures or with phone support for emergency usage. Also two types of training courses are provided for physicians, nurses and technicians: one for staff performing the procedure with the Impella and the second for staff taking care of patients after the procedure. This is important for the first cases when this new technology is implemented.
The results are presented as the number of patients or mean ± standard deviation where applicable.

Results

A total of 10 patients were treated with Impella CP support from April 2013 to August 2015 (four in 2013/14 and six in 2015). In all cases except one, the Impella CP was used during high-risk elective PCI, and the present analysis is focused on those nine patients. In this one excluded case, the Impella CP was used due to an acute MI complicated with cardiogenic shock. Baseline characteristics of enrolled patients are summarized in Table I. All patients were men with a mean age of 73 ±11 years and mean left ventricular ejection fraction of 32...


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