title: 2015 SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care (Endorsed by the American Heart Association, 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).
abstract: Although historically the intra-aortic balloon pump has been the only mechanical circulatory support device available to clinicians, a number of new devices have become commercially available and have entered clinical practice. These include axial flow pumps, such as Impella(®); left atrial to femoral artery bypass pumps, specifically the TandemHeart; and new devices for institution of extracorporeal membrane oxygenation. These devices differ significantly in their hemodynamic effects, insertion, monitoring, and clinical applicability. This document reviews the physiologic impact on the circulation of these devices and their use in specific clinical situations. These situations include patients undergoing high-risk percutaneous coronary intervention, those presenting with cardiogenic shock, and acute decompensated heart failure. Specialized uses for right-sided support and in pediatric populations are discussed and the clinical utility of mechanical circulatory support devices is reviewed, as are the American College of Cardiology/American Heart Association clinical practice guidelines.
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota. Electronic address: rihal@mayo.edu.
authors.forename: Charanjit S
authors.initials: CS
authors.lastname: Rihal
authors.affiliation: Division of Cardiology, Winthrop University Hospital, Mineola, New York.
authors.forename: Srihari S
authors.initials: SS
authors.lastname: Naidu
authors.affiliation: Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Givertz
authors.affiliation: Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Wilson Y
authors.initials: WY
authors.lastname: Szeto
authors.affiliation: Division of Cardiology, Lehigh Valley Heart Specialists, Allentown, Pennsylvania.
authors.forename: James A
authors.initials: JA
authors.lastname: Burke
authors.affiliation: Cardiology, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Navin K
authors.initials: NK
authors.lastname: Kapur
authors.affiliation: Division of Cardiology, UCI Medical Center, Orange, California.
authors.forename: Morton
authors.initials: M
authors.lastname: Kern
authors.affiliation: Department of Cardiac and Vascular Services, Heart and Vascular Institute of New York, Lenox Hill Hospital, New York, New York.
authors.forename: Kirk N
authors.initials: KN
authors.lastname: Garratt
authors.affiliation: Division of Cardiology, Beaumont Heart Center Clinic, Royal Oak, Michigan.
authors.forename: James A
authors.initials: JA
authors.lastname: Goldstein
authors.affiliation: Pediatric Cardiology, UT Southwestern, Dallas, Texas.
authors.forename: Vivian
authors.initials: V
authors.lastname: Dimas
authors.affiliation: Louisville Cardiology Group, Interventional Cardiology, Louisville, Kentucky.
authors.forename: Thomas
authors.initials: T
authors.lastname: Tu
mesh_terms: D001243:Assisted Circulation / Q000295:instrumentation / Q000379:methods; D032921:Consensus; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006353:Heart-Assist Devices / Q000145:classification*; D006439:Hemodynamics; D006801:Humans; D007391:International Cooperation; D017410:Practice Guidelines as Topic
keywords: Ventricular assist device; cardiogenic; percutaneous coronary intervention; shock