Cor Vasa 2010, 52(3):141-144 | DOI: 10.33678/cor.2010.039
Prophylactic use of extracorporeal circulatory support with a membrane oxygenator in high-risk percutaneous coronary intervention
- 1 Kardiologické oddělení, Kardiocentrum, Nemocnice Na Homolce, Praha
- 2 Kardiochirurgické oddělení, Kardiocentrum, Nemocnice Na Homolce, Praha
- 3 Oddělení biomedicínského inženýrství, Nemocnice Na Homolce, Praha
- 4 I. interní klinika, Fakultní nemocnice Olomouc, Česká republika
Prophylactic use of mechanical circulatory support in high-risk percutaneous coronary intervention (PCI) is an approach designed to reduce the risk of periprocedural complications in patients with critical coronary lesions and co-existing severe left ventricular dysfunction, associated heart valve disease, hemodynamic or electrical instability, and severe non-cardiac comorbidity. However, the currently most-oft used support systems do not allow eliminating complete circulatory arrest or are too overcomplicated to set up.
An alternative to the current common methods is the use of an extracorporeal circuit with an in-built extracorporeal membrane oxygenator (ECMO) capable of replacing a patient's circulation as needed. By August 2009, we employed the system in a total of 12 patients, of this number, in five as support to high-risk PCI performed in our center. The present paper summarizes our initial experience with three systems available from different manufacturers, their advantages, potential uses, and limitations.
Use of extracorporeal circulatory support in the setting of a department of cardiology of a heart center is feasible, both technically and organizationally, and seems to hold promise for managing the most serious complications during high-risk PCI. In addition, introduction of this technique has helped to identify other potential uses such as in cardiogenic shock, irreversible by standard measures.
Keywords: Extracorporeal circulation; Mechanical circulatory support; Extracorporeal membrane oxygenation; Percutaneous coronary intervention
Published: March 1, 2010 Show citation
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