The Use of Cardioprotective Devices and Strategies in Patients Undergoing Percutaneous Procedures and Cardiac Surgery.
Toufik Abdul-RahmanIleana Lizano-JubertNeil GargEmilio Tejerina-MarionSyed Muhammad Awais BukhariAna Luisa EkAndrew Awuah WirekoAdriana C MaresVladyslav SikoraRahul GuptaPublished in: Healthcare (Basel, Switzerland) (2023)
In the United States, about one million people are seen to visit the operating theater for cardiac surgery annually. However, nearly half of these visits result in complications such as renal, neurological, and cardiac injury of varying degrees. Historically, many mechanisms and approaches have been explored in attempts to reduce injuries associated with cardiac surgery and percutaneous procedures. Devices such as cardioplegia, mechanical circulatory support, and other methods have shown promising results in managing and preventing life-threatening cardiac-surgery-related outcomes such as heart failure and cardiogenic shock. Comparably, cardioprotective devices such as TandemHeart, Impella family devices, and venoarterial extracorporeal membrane oxygenation (VA-ECMO) have also been proven to show significant cardioprotection through mechanical support. However, their use as interventional agents in the prevention of hemodynamic changes due to cardiac surgery or percutaneous interventions has been correlated with adverse effects. This can lead to a rebound increased risk of mortality in high-risk patients who undergo cardiac surgery. Further research is necessary to delineate and stratify patients into appropriate cardioprotective device groups. Furthermore, the use of one device over another in terms of efficacy remains controversial and further research is necessary to assess device potential in different settings. Clinical research is also needed regarding novel strategies and targets, such as transcutaneous vagus stimulation and supersaturated oxygen therapy, aimed at reducing mortality among high-risk cardiac surgery patients. This review explores the recent advances regarding the use of cardioprotective devices in patients undergoing percutaneous procedures and cardiac surgery.
Keyphrases
- cardiac surgery
- extracorporeal membrane oxygenation
- acute kidney injury
- acute respiratory distress syndrome
- patients undergoing
- heart failure
- minimally invasive
- end stage renal disease
- ultrasound guided
- ejection fraction
- newly diagnosed
- risk factors
- cardiovascular disease
- type diabetes
- radiofrequency ablation
- left ventricular
- prognostic factors
- cardiovascular events
- peritoneal dialysis
- patient reported
- mechanical ventilation
- adipose tissue
- brain injury
- physical activity
- subarachnoid hemorrhage
- respiratory failure
- smoking cessation
- skeletal muscle
- atrial fibrillation
- glycemic control
- cerebral ischemia
- insulin resistance