Percutaneous Cardiopulmonary Support-Supported Percutaneous Coronary Intervention: A Single Center Experience.
10.4070/kcj.2011.41.6.299
- Author:
Sung Soo CHO
1
;
Chang Myung OH
;
Ji Yong JANG
;
Hee Tae YU
;
Woo Dae BANG
;
Jung Sun KIM
;
Young Guk KO
;
Donghoon CHOI
;
Myeong Ki HONG
;
Won Heum SHIM
;
Seung Yun CHO
;
Yangsoo JANG
Author Information
1. Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, Korea. jangys1212@yuhs.ac
- Publication Type:Original Article
- Keywords:
Shock, cardiogenic
- MeSH:
Disease-Free Survival;
Emergencies;
Humans;
Korea;
Myocardial Infarction;
Myocardium;
Percutaneous Coronary Intervention;
Retrospective Studies;
Shock, Cardiogenic;
Survival Rate;
Survivors
- From:Korean Circulation Journal
2011;41(6):299-303
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: Percutaneous cardiopulmonary support (PCPS) has proven to be a valuable technique in high-risk coronary patients undergoing percutaneous coronary intervention (PCI). However, there have been few studies on PCI associated with PCPS in Korea. We summarized our experience with PCPS-supported PCI. SUBJECTS AND METHODS: We retrospectively reviewed 19 patients with PCPS-supported PCI between August 2005 and June 2009. PCPS was used as an elective procedure for 10 patients with at least two of the following conditions: left-ventricular ejection fraction <35%, target vessel(s) supplying more than 50% of the viable myocardium, high risk surgical patients, and patients who refused coronary bypass surgery. In the remaining 9 patients PCPS was used as an emergency procedure, to stabilize and even resuscitate patients with acute myocardial infarction and cardiogenic shock, in order to attempt urgent PCI. RESULTS: Among the 19 patients who were treated with PCPS-supported PCI, 11 (57.9%) survived and 8 (42.1%) patients did not. ST elevation myocardial infarction with cardiogenic shock was more prevalent in the non-survivors than in the survivors (75% vs. 27.3%, p=0.04). The elective PCPS-supported PCI was practiced more frequently in the survivors than in the non-survivors (72.7% vs. 25%, p=0.04). In the analysis of the event-free survival curve between elective and emergency procedures, there was a significant difference in the survival rate (p=0.025). Among the survivors there were more patients with multi-vessel disease, but a lower Thrombolysis in Myocardial Infarction grade in the culprit lesions was detected in the non-survivors, before PCI. Although we studied high-risk patients, there was no procedure-related mortality. CONCLUSION: Our experience suggests that PCPS may be helpful in high risk patients treated with PCI, especially in elective cases. More aggressive and larger scale studies of PCPS should follow.
