Mechanical Circulatory Support for High-Risk Pulmonary Embolism

Mahir Elder; Nimrod Blank; Adi Shemesh; Mohit Pahuja; Amir Kaki; Tamam Mohamad; Theodore Schreiber; Jay Giri

doi:10.1016/j.iccl.2017.09.002

Mechanical Circulatory Support for High-Risk Pulmonary Embolism

Interv Cardiol Clin. 2018 Jan;7(1):119-128. doi: 10.1016/j.iccl.2017.09.002.

Authors

Mahir Elder¹, Nimrod Blank², Adi Shemesh², Mohit Pahuja², Amir Kaki², Tamam Mohamad², Theodore Schreiber², Jay Giri³

Affiliations

¹ Department of Medicine, Detroit Medical Center, Wayne State University, 4160 John R Street, Suite 510, Detroit, MI 48201, USA. Electronic address: [email protected].
² Department of Medicine, Detroit Medical Center, Wayne State University, 4160 John R Street, Suite 510, Detroit, MI 48201, USA.
³ Division of Cardiovascular Medicine, Penn Cardiovascular Outcomes, Quality and Evaluative Research Center, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA.

PMID: 29157518
DOI: 10.1016/j.iccl.2017.09.002

Abstract

Temporary mechanical circulatory support (MCS) devices have a role in treating high-risk patients with pulmonary embolism with cardiogenic shock. Mechanical circulatory device selection should be made based on center experience and device-specific features. All current devices are effective in decreasing right arterial pressure and providing circulatory support of 4 to 5 L/min. The pulmonary artery pulsatility index may prove to be an unreliable method to assess right ventricular function. Careful clinical evaluation on an individual patient basis should determine the need for MCS.

Keywords: Cardiogenic shock; Mechanical circulatory support; Pulmonary embolism; Right ventricular failure.

Publication types

Review

MeSH terms

Extracorporeal Membrane Oxygenation / methods*
Heart-Assist Devices*
Humans
Pulmonary Embolism / complications
Pulmonary Embolism / surgery*
Risk Factors
Shock, Cardiogenic / etiology*
Shock, Cardiogenic / surgery