Konstantinou_et_al_2019.pdf (823.07 kB)
Protected percutaneous coronary intervention with Impella CP in a patient with left main disease, severe left ventricular systolic dysfunction and established hemolysis
journal contribution
posted on 2023-07-26, 14:41 authored by Klio Konstantinou, Thomas R. Keeble, Paul A. Kelly, Osama Alsanjari, L. Christian Napp, Grigoris V. Karamasis, John R. Daviesbstract: The use of the Impella device in patients with left ventricular (LV) systolic impairment undergoing left main (LM) percutaneous coronary intervention (PCI) has been growing exponentially. Data from observational studies and registries demonstrate that Impella-assisted high-risk PCI is safe and effective with a low rate of peri-procedural complications. Hemolysis is a potential limitation of virtually all mechanical circulatory support devices and a small incidence of hemolysis has been associated with Impella use. The safety and feasibility of Impella use in patients with established hemolysis has not been previously evaluated. We report the first described case in the literature of Impella-assisted left main stem (LMS) PCI in a patient with severe LV systolic dysfunction and autoimmune hemolytic anemia (AIHA). Despite the patient's high bleeding risk (active hemolysis, thrombocytopenia, impaired renal function, use of steroids), Impella placement and PCI were successfully performed without complication. Haemoglobin, bilirubin and lactate dehydrogenase (LDH) levels were closely monitored peri-procedurally with no evidence of exacerbation of the patient’s hemolysis. We briefly discuss the mechanism of Impella-induced hemolysis and factors that can exacerbate hemolysis.
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Refereed
- Yes
Volume
9Issue number
2Page range
194-199Publication title
Cardiovascular Diagnosis and TherapyISSN
2223-3660External DOI
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AME PublishingFile version
- Published version
Language
- eng
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2019-07-17Legacy creation date
2019-07-31Legacy Faculty/School/Department
Faculty of Health, Education, Medicine & Social CareUsage metrics
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