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KMID : 0368120110410060299
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Korean Circulation Journal
2011 Volume.41 No. 6 p.299 ~ p.303
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Percutaneous Cardiopulmonary Support-Supported Percutaneous Coronary Intervention: A Single Center Experience
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Cho Sung-Soo
Oh Chang-Myung
Jang Ji-Yong
Yu Hee-Tae
Bang Woo-Dae
Kim Jung-Sun
Ko Young-Guk
Choi Dong-Hoon
Hong Myeong-Ki
Shim Won-Heum
Cho Seung-Yun
Jang Yang-Soo
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Abstract
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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.
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KEYWORD
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Shock, cardiogenic
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