Veno-arterial CardioHelp can be used in cardiogenic shock, massive pulmonary embolism with RV strain, for transport between facilities, and in high-risk PCI with severely depressed LVEF. It can be inserted in the cath lab and offers cardiac output up to 5 L/min. The CardioHelp device is the smallest portable heart-lung support system designed for patients needing extended circulatory and/or respiratory support without the need of a perfusionist. I believe every interventional fellow should learn its importance as it is part of the future of heart failure optimization. Shavelle, MD, co-author of the CHAMPION trial, is one of my mentors at the University of Southern California and introduced the technology at our institution and to me. The CHAMPION trial showed a 37% reduction in heart failure-related hospitalizations using the CardioMems system compared with standard therapy. Afterward, clopidogrel is given for 30 days. The balloon wedge pressure catheter is reinserted, and pulmonary pressure recorded and calibrated with the CardioMems device. Then the device, which is radio-opaque, is deployed after positioning is confirmed with contrast injection. The balloon wedge pressure catheter is removed, and the delivery system is advanced over a 0.018” guidewire into the lower lateral branch of the left pulmonary artery.
Right heart catheterization is performed using a 7-Fr balloon wedge pressure catheter, and then an angiogram of the left lower pulmonary artery is performed and selected for implantation of the device.
The device is placed via venous access-usually the femoral vein-using a 12-Fr sheath. The CardioMems system is FDA approved for patients with NYHA class III heart failure symptoms and who were hospitalized for decompensated heart failure within the last year. Two newly approved devices-the CardioMems heart failure monitoring system (St Jude Medical) and the CardioHelp heart-lung support system (Maquet)-have impressed me so much so that I’d like to share my experiences with them. One of the benefits of interventional cardiology fellowship training is the exposure to new technology.
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