Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Percutaneous Cardiopulmonary Support-Supported Percutaneous Coronary Intervention: A Single Center Experience

  • Cho, Sung-Soo (Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine) ;
  • Oh, Chang-Myung (Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine) ;
  • Jang, Ji-Yong (Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine) ;
  • Yu, Hee-Tae (Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine) ;
  • Bang, Woo-Dae (Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine) ;
  • Kim, Jung-Sun (Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine) ;
  • Ko, Young-Guk (Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine) ;
  • Choi, Dong-Hoon (Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine) ;
  • Hong, Myeong-Ki (Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine) ;
  • Shim, Won-Heum (Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine) ;
  • Cho, Seung-Yun (Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine) ;
  • Jang, Yang-Soo (Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine)
  • Published : 2011.06.30
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Abstract

Background and Objectives: Percutaneous cardiopulmonary support (PCPS) has proven to be a valuable technique in high-risk coronary patients undergoing percutaneous coronary intervention (PCI). However, there have been few studies on PCI associated with PCPS in Korea. We summarized our experience with PCPS-supported PCI. Subjects and Methods: We retrospectively reviewed 19 patients with PCPS-supported PCI between August 2005 and June 2009. PCPS was used as an elective procedure for 10 patients with at least two of the following conditions: left-ventricular ejection fraction <35%, target vessel(s) supplying more than 50% of the viable myocardium, high risk surgical patients, and patients who refused coronary by-pass surgery. In the remaining 9 patients PCPS was used as an emergency procedure, to stabilize and even resuscitate patients with acute myocardial infarction and cardiogenic shock, in order to attempt urgent PCI. Results: Among the 19 patients who were treated with PCPS-supported PCI, 11 (57.9%) survived and 8 (42.1%) patients did not. ST elevation myocardial infarction with cardiogenic shock was more prevalent in the non-survivors than in the survivors (75% vs. 27.3%, p=0.04). The elective PCPS-supported PCI was practiced more frequently in the survivors than in the non-survivors (72.7% vs. 25%, p=0.04). In the analysis of the event-free survival curve between elective and emergency procedures, there was a significant difference in the survival rate (p=0.025). Among the survivors there were more patients with multi-vessel disease, but a lower Thrombolysis in Myocardial Infarction grade in the culprit lesions was detected in the non-survivors, before PCI. Although we studied high-risk patients, there was no procedure-related mortality. Conclusion: Our experience suggests that PCPS may be helpful in high risk patients treated with PCI, especially in elective cases. More aggressive and larger scale studies of PCPS should follow.

Keywords

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