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Jeindl, R. and Goetz, G. (2021): Percutaneous left ventricular assist devices: micro-axial flow pumps. Decision Support Document 124.

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Abstract

Myocardial infarction with failure of the left ventricle can cause cardiogenic shock, which is associated with a high mortality. Percutaneous coronary interventions are minimally invasive procedures for revascularisation. Temporary mechanical circulatory support may be considered for both indications. Mechanical circulatory support can be provided by micro-axial percutaneous left ventricular assist devices (pLVAD).

This report updates the evidence synthesis published by Health Quality Ontario in 2017. In total, the updated evidence synthesis included seven studies (4 RCTs and 3 registry studies). The overall quality of the evidence for effectiveness and safety was rated as very low (GRADE rating).

None of the RCTs demonstrated a statistically significant reduction in mortality in favour of the technology. For both indications, the evidence suggested improved haemodynamics with the technology. However, a statistically significant difference in bleeding to the detriment of the technology was shown. Given the available evidence and potential risks, results from ongoing studies should be awaited. The inclusion in the Austrian benefit catalogue is currently not recommended.

Item Type:Decision Support Document
Keywords:Left ventricular assist device, cardiogenic shock, percutaneous coronary intervention, micro-axial flow pump, mechanical circulatory support
Subjects:W Health professions > W 100-275 Medical, dental and pharmaceutical service plans
WB Practice of medicine > WB 105 Emergency medicine
WB Practice of medicine > WB 300-962 Therapeutics
WG Cardiovascular system
WO Surgery > WO 500-517 Operative surgical procedures. Techniques
WO Surgery > WO 505 Minimally invasive surgical procedures
Language:English
Series Name:Decision Support Document 124
Deposited on:15 Jul 2021 07:27
Last Modified:15 Jul 2021 07:27

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