Percutaneous Ventricular Assist Devices

Percutaneous ventricular assist devices may be used as circulatory support in (high-risk) percutaneous coronary intervention (PCI) or in patients with compromised heart function. Randomized trials in the field of mechanical circulatory support are limited by small sample sizes and obvious selection bias exists in non-randomized studies. Thus far, none of the devices has proven to be superior in improving patient outcomes. Therefore, current guidelines recommend that percutaneous ventricular assist devices may be considered in selected patients, particularly in refractory cardiogenic shock (Class IIa C recommendation). The routine use of intra-aortic balloon pump (IABP) in patients with cardiogenic shock complicating myocardial infarction is no longer recommended (class III recommendation). This chapter gives an overview of the current evidence, device characteristics and application of the IABP, Impella devices, TandemHeart device, Heartmate PHP (percutaneous heart pump), ProtekDuo (LivaNova) and extracorporeal membrane oxygenation (ECMO) system.