Patients who require coronary revascularization and present with poor left ventricular function and complex coronary anatomy are at high risk for percutaneous coronary intervention (PCI) and coronary artery bypass grafting surgery. Some of these patients are poor surgical candidates because of previous cardiac surgery or significant comorbidities. The recent approval and availability of percutaneous left ventricular assist devices has created an opportunity for the highest risk patients. This article reviews currently available mechanical circulatory support systems and portable extracorporeal oxygenation, describing hemodynamic and physiologic rationales, indications, strategies, and available evidence for their use in high risk PCI.
- Coronary interventions
- High risk
- Percutaneous left ventricular assist devices
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine