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Cardiac intensive care management of high-risk percutaneous coronary intervention using the venoarterial ECMO support

  • Marco Zuin
  • Gianluca RigatelliEmail author
  • Ramesh Daggubati
Article
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Abstract

The emerging concept of high-risk percutaneous coronary intervention (HR-PCI) has required the adoption of a multidisciplinary team approach. Venoarterial ECMO (VA-ECMO) has been introduced as a temporary mechanical circulatory support (MCS) for HR-PCI patients in order to provide an adequate systemic perfusion during the procedure. Both patient’s complexity and technological evolutions have catalyzed the development of critical care cardiology; however, ECMO therapy faces several challenges. Indeed, the management of patients on ECMO remains complex; moreover, the lack of specific recommendation for HR-PCI patients further complicates the management of these patients. In this narrative review, we give a reappraisal for the management of HR-PCI patients supported with VA-ECMO according to the available data published in current literature.

Keywords

Mechanical circulatory support Intensive care unit Shock Critical care Hemodynamic monitoring High-risk PCI VA-ECMO 

Abbreviations

AMI

Acute myocardial infarction

CAD

Coronary artery disease

CCU

Cardiac care unit

HR-PCI

High-risk percutaneous coronary intervention

IABP

Intra-aortic balloon pump

LV

Left ventricle

MCS

Mechanical circulatory support

PCI

Percutaneous coronary intervention

pVAD

Percutaneous ventricle assists devices

VA-ECMO

Venoarterial ECMO

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Authors and Affiliations

  1. 1.Faculty of Medicine, Section of Internal and Cardiopulmonary MedicineUniversity of FerraraFerraraItaly
  2. 2.Cardiovascular Diagnosis and Endoluminal Interventions UnitRovigo General HospitalRovigoItaly
  3. 3.Division of Cardiology, Department of MedicineNYU Winthrop HospitalMineolaUSA

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