Unprotected Left Main Percutaneous Coronary Intervention in Acute Coronary Syndromes with Extracorporeal Life Support BackupReport as inadecuate




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Scientifica - Volume 2015 2015, Article ID 435878, 5 pages -

Clinical Study

Department of Cardiology and Angiology, Heart Center Freiburg University, Hugstetterstrasse 55, 79106 Freiburg im Breisgau, Germany

Department of Cardiovascular Surgery, Heart Center Freiburg University, Hugstetterstrasse 55, 79106 Freiburg im Breisgau, Germany

Received 10 November 2014; Accepted 9 February 2015

Academic Editor: Michael S. Firstenberg

Copyright © 2015 Dawid L. Staudacher et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Left main PCI is superior to coronary bypass surgery in selected patients. Registry data, however, suggest significant early adverse event rates associated with unprotected left main PCI. We aimed to evaluate safety of an extracorporeal life support ECLS as backup system during PCI. Methods. We report a registry study of 16 high-risk patients presenting with acute coronary syndromes undergoing unprotected left main PCI with an ECLS backup. Results. Seven patients 43.8% presented with an acute myocardial infarction while 9 patients 56.3% had unstable angina. Unprotected left main PCI could be successfully performed in all 16 patients. Mortality or thromboembolic event rates were zero within the index hospital stay. General anesthesia was necessary only in 5 patients 31.3%. Access site bleeding requiring transfusion was encountered in 4 patients 25.0%. Three patients 18.8% developed access site complications requiring surgical intervention. All patients were ECLS-free after 96 hours. Conclusions. Unprotected left main PCI could be safely and effectively performed after ECLS implantation as backup in acute coronary syndromes in our patient collectively. Vascular access site complications however need to be considered when applying ECLS as backup system.





Author: Dawid L. Staudacher, Oliver Langner, Paul Biever, Christoph Benk, Manfred Zehender, Christoph Bode, and Tobias Wengenmayer

Source: https://www.hindawi.com/



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