A11 - Assessment of High-risk Percutaneous Coronary Intervention Haemodynamics with Pressure– volume Loop Analysis

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Support:The development of this supplement was funded by Abiomed.

Correspondence Details:Mohammad Alqarqaz,

Open Access:

The copyright in this work belongs to Radcliffe Medical Media. Only articles clearly marked with the CC BY-NC logo are published with the Creative Commons by Attribution Licence. The CC BY-NC option was not available for Radcliffe journals before 1 January 2019. Articles marked ‘Open Access’ but not marked ‘CC BY-NC’ are made freely accessible at the time of publication but are subject to standard copyright law regarding reproduction and distribution. Permission is required for reuse of this content.

Background: Pressure–volume loops (PVLs) can provide valuable information about left ventricular (LV) contractility and loading conditions. Acquiring PVLs in real time during high-risk percutaneous coronary intervention (HR-PCI) may improve our understanding of procedural haemodynamic changes and the impact of haemodynamic support devices.

Hypothesis: We sought to examine the feasibility and utility of PVL analysis in assessing changes in LV contractility and loading conditions during HR-PCI performed with and without Impella mechanical circulatory support (MCS).

Methods: We enrolled nine patients who underwent HR-PCI at two tertiary centres. Six patients had Impella CP device support. LV pressures and volumes were measured with a conductance catheter at different device flow levels and at key timepoints during the procedure. PVLs were analysed to detect changes in LV contractility and loading conditions.

Conclusion: During HR-PCI, good-quality PVL acquisition and analysis was feasible, even in patients with Impella support. PVLs can detect real-time changes in LV contractility and loading conditions, including changes related to different procedural manoeuvres (e.g. balloon inflations). PVL analysis can improve our understanding of the haemodynamic changes during HR-PCI and potentially guide appropriate MCS device selection for patients who require a supported HR-PCI.