Journal of the American College of Cardiology
Expert Consensus Document
2015 SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular CareEndorsed by the American Heart Assocation, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencion; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie d’intervention
Charanjit S. Rihal, Srihari S. Naidu, Michael M. Givertz, Wilson Y. Szeto, James A. Burke, Navin K. Kapur, Morton Kern, Kirk N. Garratt, James A. Goldstein, Vivian Dimas, Thomas Tu, Society for Cardiovascular Angiography and Interventions (SCAI), Heart Failure Society of America (HFSA), Society of Thoracic Surgeons (STS) and American Heart Association (AHA), and American College of Cardiology (ACC)
Table 2
Table 2
Suggested Schema for Support Device in High-Risk PCI
| Patient With Left Main, Last Remaining Conduit, or Severe Multivessel Disease | Anticipated Noncomplex PCI | Anticipated Technically Challenging or Prolonged PCI |
|---|---|---|
| Normal or mildly reduced left ventricular function | None | IABP/Impella as back up |
| Severe left ventricular dysfunction (EF <35%) or recent decompensated heart failure | IABP/Impella as back up | Impella or TandemHeart, choice dependent upon vascular anatomy, local expertise, and availability. ECMO for concomitant hypoxemia or RV failure. |
A suggested schema for use of support devices for high-risk PCI based upon clinical and anatomic circumstances. The greater the likelihood of hemodynamic compromise or collapse the greater the potential benefit of MCS.
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