Dr. Navin Kapur Discusses pMCS devices at CHIP Course
As part of the “CHIP: Hemodynamic Support and Complex PCI” event, Dr. Navin Kapur from Tufts Medical Center discussed percutaneous devices for mechanical circulatory support, demonstrating a patient case with advanced congestive heart failure and multi-vessel coronary artery disease. Dr. Kapur noted that less than 20% of patients with congestive heart failure are evaluated for ischemic heart disease. Dr. Kapur’s patient was evaluated with thallium testing, which revealed viable myocardiaum appropriate for revascularization. Dr. Kapur discussed this case in terms of the hemodynamic support equation, which consists of circulatory support, ventricular support and coronary perfusion, as detailed below:
Dr. Kapur emphasized that circulatory support, ventricular support, and coronary perfusion are the three elements of mechanical circulatory support (MCS). The goal of MCS is pressure and volume unloading. He compared and contrasted various technologies used for MCS today, including the Tandem Heart device, extracorporeal membrane oxygenation (“ECMO”) and the IABP, in addition to the Impella platform of devices.
- Learn more about the hemodynamics of Protected PCI with the Impella 2.5 heart pump
- Learn more about the clinical data associated with Protected PCI
The Impella 2.5 system is a temporary (<6 hours) ventricular support device indicated for use during high-risk percutaneous coronary interventions (PCI) performed in elective or urgent, hemodynamically stable patients with severe coronary artery disease and depressed left ventricular ejection fraction, when a heart team, including a cardiac surgeon, has determined high-risk PCI is the appropriate therapeutic option. Use of the Impella 2.5 in these patients may prevent hemodynamic instability which can result from repeat episodes of reversible myocardial ischemia that occur during planned temporary coronary occlusions and may reduce peri- and post-procedural adverse events.
Protected PCI and use of the Impella 2.5 is not right for every patient. Patients may not be able to be treated with Impella if they have certain pre-existing conditions, which a cardiologist can determine, such as: severe narrowing of the heart valve, severe peripheral artery disease, clots in blood vessels, or a replacement heart valve or certain heart valve deficiencies. Additionally, use of Impella has been associated with risks, including, but not limited to valvular and vascular injury, bleeding, and limb ischemia in certain patients. Learn more about the Impella devices’ approved indications for use, as well as important safety and risk information at www.protectedpci.com/indications-use-safety-information/.