Meta-Analysis of Usefulness of Percutaneous Left Ventricular Assist Devices for High-Risk Percutaneous Coronary Interventions

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• 作者：Alexandros Briasoulis ; MD ; ^{alexbriasoulis@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Tesfaye Telila ; MD ; Mohan Palla ; MD ; Nestor Mercado ; MD ; Ashok Kondur ; MD ; Cindy Grines ; MD ; Theodore Schreiber ; MD
• 刊名：The American Journal of Cardiology
• 出版年：2016
• 出版时间：1 August 2016
• 年：2016
• 卷：118
• 期：3
• 页码：369-375
• 全文大小：1580 K

文摘

High-risk percutaneous coronary intervention (PCI) is often offered to patients with extensive coronary artery disease, decreased left ventricular function, and co-morbid conditions that increase surgical risk. In these settings, percutaneous left ventricular assist devices (PVADs) can be used for hemodynamic support. To assess the effects of PVAD use on mortality, myocardial infarction, and complication rates in patients undergoing high-risk PCI, we systematically searched the electronic databases, MEDLINE, PUBMED, EMBASE, and Cochrane for prospective controlled trials and cohort studies of patients that received hemodynamic support with PVADs for high-risk PCI. The primary outcome measures were 30-day all-cause mortality, 30-day myocardial infarction rates, periprocedural major bleeding, and vascular complications. We included 12 studies with 1,346 participants who underwent Impella 2.5 L device placement and 8 cohort studies with 205 patients that received TandemHeart device for high-risk PCI. Short-term mortality rates were 3.5% and 8% and major bleeding rates were 7.1% and 3.6% with Impella and TandemHeart, respectively. Both devices are associated with comparable periprocedural outcomes in patients undergoing high-risk PCI.