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Outcomes of bailout percutaneous ventricular assist device versus prophylactic strategy in patients undergoing nonemergent percutaneous coronary intervention.

Publication ,  Journal Article
O'Neill, BP; Grines, C; Moses, JW; Ohman, EM; Lansky, A; Popma, J; Kapur, NK; Schreiber, T; Mannino, S; O'Neill, WW; Medjamia, AM; Mahmud, E
Published in: Catheter Cardiovasc Interv
October 2021

OBJECTIVES: To compare in-hospital outcomes of bailout support to prophylactic support with percutaneous ventricular assist devices (pVAD) for high-risk nonemergent percutaneous coronary intervention (HRPCI). BACKGROUND: Prophylactic support with pVAD for a HRPCI is used in patients felt to be at risk for hemodynamic collapse during PCI. An alternative strategy of bailout pVAD support in the event of hemodynamic collapse is also entertained. METHODS: We compared the outcomes of patients entered in the cVAD database who underwent Impella Protected PCI (ProPCI group) with patients from the cVAD and USpella databases receiving bailout Impella support for hemodynamic collapse during HRPCI (Bailout group). RESULTS: A total of 1,028 patients supported with Impella pVAD were entered into the cVAD database as of July 2019 and were included in this analysis. Of those 971 were in the ProPCI group and 57 in the Bailout group. Patients in the Bailout group were more often female (50.9%vs. 27.2%, p = .0002) with higher median baseline left ventricular ejection fraction (LVEF) (40%vs. 30%, p < .0001) and with lower prevalence of both heart failure (42.1%vs. 56.9%, p = .0385) and left main disease (40.0%vs. 56.1%, p = .0250) compared to the ProPCI group. Unadjusted and adjusted in-hospital mortality was significantly higher in the Bailout group (49.1%vs. 4.3%, and 57.8%vs. 4.4%, p < .0001 for both). CONCLUSIONS: In our study population, the bailout group was associated with significant increased mortality compared to ProPCI group. Female gender was more frequently observed in patients requiring bailout pVAD. Further investigation is warranted in order to generalize the findings of our study.

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Published In

Catheter Cardiovasc Interv

DOI

EISSN

1522-726X

Publication Date

October 2021

Volume

98

Issue

4

Start / End Page

E501 / E512

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Treatment Outcome
  • Stroke Volume
  • Risk Factors
  • Retrospective Studies
  • Percutaneous Coronary Intervention
  • Humans
  • Heart-Assist Devices
  • Female
  • Cardiovascular System & Hematology
 

Citation

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O’Neill, B. P., Grines, C., Moses, J. W., Ohman, E. M., Lansky, A., Popma, J., … Mahmud, E. (2021). Outcomes of bailout percutaneous ventricular assist device versus prophylactic strategy in patients undergoing nonemergent percutaneous coronary intervention. Catheter Cardiovasc Interv, 98(4), E501–E512. https://doi.org/10.1002/ccd.29758
O’Neill, Brian P., Cindy Grines, Jeffrey W. Moses, E Magnus Ohman, Alexandra Lansky, Jeffery Popma, Navin K. Kapur, et al. “Outcomes of bailout percutaneous ventricular assist device versus prophylactic strategy in patients undergoing nonemergent percutaneous coronary intervention.Catheter Cardiovasc Interv 98, no. 4 (October 2021): E501–12. https://doi.org/10.1002/ccd.29758.
O’Neill BP, Grines C, Moses JW, Ohman EM, Lansky A, Popma J, et al. Outcomes of bailout percutaneous ventricular assist device versus prophylactic strategy in patients undergoing nonemergent percutaneous coronary intervention. Catheter Cardiovasc Interv. 2021 Oct;98(4):E501–12.
O’Neill, Brian P., et al. “Outcomes of bailout percutaneous ventricular assist device versus prophylactic strategy in patients undergoing nonemergent percutaneous coronary intervention.Catheter Cardiovasc Interv, vol. 98, no. 4, Oct. 2021, pp. E501–12. Pubmed, doi:10.1002/ccd.29758.
O’Neill BP, Grines C, Moses JW, Ohman EM, Lansky A, Popma J, Kapur NK, Schreiber T, Mannino S, O’Neill WW, Medjamia AM, Mahmud E. Outcomes of bailout percutaneous ventricular assist device versus prophylactic strategy in patients undergoing nonemergent percutaneous coronary intervention. Catheter Cardiovasc Interv. 2021 Oct;98(4):E501–E512.
Journal cover image

Published In

Catheter Cardiovasc Interv

DOI

EISSN

1522-726X

Publication Date

October 2021

Volume

98

Issue

4

Start / End Page

E501 / E512

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Treatment Outcome
  • Stroke Volume
  • Risk Factors
  • Retrospective Studies
  • Percutaneous Coronary Intervention
  • Humans
  • Heart-Assist Devices
  • Female
  • Cardiovascular System & Hematology