Coronary Interventions with Mechanical Circulatory Support

Abstract

Patients in cardiogenic shock, with severely impaired left ventricular function, or intervention on the last open supplying coronary artery are summarized as so called “high risk coronary interventions” with significant risk of hemodynamic collapse and increased periprocedural mortality rate [1]. Thus, high risk percutaneous coronary interventions (PCI) may require prophylactic or standby hemodynamic mechanical circulatory support. While infusion of inotropic substances further increases myocardial oxygen consumption, other measures of support may be favourable especially in infarct related acute pump failure. However, in acute cardiogenic shock, mechanical circulatory support may depict the only option to stabilise the patient for intraor inter-hospital transfer and further diagnostic and therapeutic measures. This chapter summarises different therapeutic options of mechanical circulatory support in high risk PCI patients. Ongoing technical development as well as clinical studies may further elucidate this field of interventional cardiology in the future.