Expert Consensus Document
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 Assocation, 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

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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.

Key Words

ACC Expert Consensus Document
cardiogenic
percutaneous coronary intervention
shock
ventricular assist device

Cited by (0)

The document will also appear in the Journal of Cardiac Failure and Catheterization and Cardiovascular Interventions.

Conflict of interest: See Appendix A Author Relationships With Industry and Other Entities (Relevant)–SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Ventricular Assist Devices in Cardiovascular Care, Appendix B Author Relationships With Industry and Other Entities (Comprehensive)–SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Ventricular Assist Devices in Cardiovascular Care, Appendix C Peer Reviewer Relationships With Industry and Other Entities (Relevant)–SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care.

The American College of Cardiology requests that this document be cited as follows: Rihal CS, Naidu SS, Givertz MM, Szeto WY, Burker JA, Kapur NK, Kern M, Garratt KN, Goldstein JA, Dimas V, Tu T. 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 Cardiología Intervencionista; affirmation of value by the Canadian Association of Interventional Cardiology—Association Canadienne de Cardiologie d'intervention). J Am Coll Cardiol 2015;65:e7–26.

The Canadian Association of Interventional Cardiology (CAIC) is approached by other guideline developers and asked to review and consider guidelines for endorsement. Guidelines developed by external organizations will be considered for affirmation of value. The CAIC may not agree with every recommendation in such a document, but overall considers the document to be of educational value to its members.