A Smaller Pump Holds Its Ground Against ECMO in High-Risk PCI

Key Takeaway

In a randomized trial of 222 patients with severely weakened hearts undergoing planned high-risk stenting, a small pump placed inside the heart performed no worse than full ECMO on major 30-day complications. It also caused far fewer device-related problems, less anemia and a shorter hospital stay, which points toward a gentler way to protect fragile hearts during complex procedures.

When the Last Open Artery Is the One You Need to Fix

Picture a 71-year-old retired machinist whose heart pumps out barely a third of its normal output. Years of blockages have scarred his heart muscle, and the angiogram shows trouble everywhere: narrowing in all 3 major arteries and a critical blockage in the left main trunk, the artery that feeds most of the heart. Surgeons have looked at his lungs, kidneys and frailty and declined to operate. The remaining option is to open those arteries from the inside with balloons and stents.

Here is the problem. Each time the cardiologist inflates a balloon, blood flow through that artery stops briefly. A healthy…