title: Percutaneous coronary intervention with the TandemHeart™ percutaneous left ventricular assist device support: Six years of experience and outcomes.
abstract: OBJECTIVE
  Our study was designed to evaluate the outcomes of TandemHeart™ assistance during percutaneous coronary intervention, specifically in relationship to pre-procedural clinical and hemodynamic risk factors in patients ineligible for surgical revascularization.
  
  
  BACKGROUND
  We have used the TandemHeart™ percutaneous left ventricular assist device during percutaneous coronary intervention (PCI) in patients for whom conventional PCI and aorto-coronary bypass would pose substantial risk owing to comorbidities and/or clinical presentations.
  
  
  METHODS
  We retrospectively analyzed data from 626 consecutive PCIs at the Texas Heart Institute from 2005 to 2011. Among these, 74 interventions were performed with TandemHeart™ support. Mortality and morbidity were analyzed in relationship to presentation status (elective, urgent, emergent, or emergent salvage), and then we recorded outcomes and survival rates over the course of six years.
  
  
  RESULTS
  At 30 days after PCI, survival rates were 94%, 88%, 79%, and 55% in the elective, urgent, emergent, and emergent salvage groups, respectively. Survival rates at one year were at 75% in the elective, 64% in the urgent, 52% in the emergent, and 45% in the emergent salvage groups. Survival rates at 6 years were 68% in the elective, 53% in the urgent, 31% in the emergent, and 41% in the emergent salvage groups, respectively. In elective and urgent groups, successful weaning from mechanical support was possible in all patients. In the emergent and emergent salvage groups, successful weaning from mechanical support was possible in 84% and 55% of patients, respectively.
  
  
  CONCLUSIONS
  TandemHeart™ assisted PCI is a viable option for revascularization in cases of profound cardiogenic shock or extremely risky intervention due to complex anatomy. © 2015 Wiley Periodicals, Inc.
authors.affiliation: Department of Cardiology, Center for Cardiac Support, Texas Heart Institute at St. Luke's Health System, Houston, Texas.|Department of Cardiovascular Surgery, Center for Cardiac Support, Texas Heart Institute at St. Luke's Health System, Houston, Texas.|Center for Advanced Heart Failure and Heart Transplantation, Memorial Hermann Heart & Vascular Institute at the Texas Medical Center, University of Texas Health Science Center, Houston, Texas.
authors.forename: Angelo
authors.initials: A
authors.lastname: Nascimbene
authors.affiliation: Department of Cardiology, Center for Cardiac Support, Texas Heart Institute at St. Luke's Health System, Houston, Texas.|Department of Cardiovascular Surgery, Center for Cardiac Support, Texas Heart Institute at St. Luke's Health System, Houston, Texas.|Center for Advanced Heart Failure and Heart Transplantation, Memorial Hermann Heart & Vascular Institute at the Texas Medical Center, University of Texas Health Science Center, Houston, Texas.
authors.forename: Pranav
authors.initials: P
authors.lastname: Loyalka
authors.affiliation: Department of Cardiology, Center for Cardiac Support, Texas Heart Institute at St. Luke's Health System, Houston, Texas.|Department of Cardiovascular Surgery, Center for Cardiac Support, Texas Heart Institute at St. Luke's Health System, Houston, Texas.|Center for Advanced Heart Failure and Heart Transplantation, Memorial Hermann Heart & Vascular Institute at the Texas Medical Center, University of Texas Health Science Center, Houston, Texas.
authors.forename: Igor D
authors.initials: ID
authors.lastname: Gregoric
authors.affiliation: Department of Cardiology, Center for Cardiac Support, Texas Heart Institute at St. Luke's Health System, Houston, Texas.|Department of Cardiovascular Surgery, Center for Cardiac Support, Texas Heart Institute at St. Luke's Health System, Houston, Texas.|Center for Advanced Heart Failure and Heart Transplantation, Memorial Hermann Heart & Vascular Institute at the Texas Medical Center, University of Texas Health Science Center, Houston, Texas.
authors.forename: Biswajit
authors.initials: B
authors.lastname: Kar
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006353:Heart-Assist Devices; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D012189:Retrospective Studies; D012770:Shock, Cardiogenic / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate / Q000639:trends; D013781:Texas / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
keywords: LVAD; PCI; cardiogenic shock; elective revascularization