Alternative Access for Mechanical Circulatory Support

ABSTRACT

Technological advancements and the development of shock teams and protocols have led to increasing utilization of mechanical circulatory support (MCS) devices. These large-bore devices are used to provide hemodynamic support in patients undergoing complex cardiovascular procedures and to support end-organ perfusion in those with heart failure or cardiogenic shock. Vascular access complications are common and limit the therapeutic and hemodynamic benefits of such devices. In this review, the authors discuss common techniques used to overcome hostile femoral anatomy and review alternative accesses that can be used for the safe delivery of MCS devices.

KEYWORDS:

• Large bore access
• alternative access
• mechanical circulatory support

Disclosure statement

MBB is a consultant for Abbott Vascular, Abiomed, Cardiovascular Systems, Chiesi, Procyrion and Zoll. MHE is a clinical proctor for Edwards Lifesciences, Medtronic and Boston Scientific. MBA is a consultant for Abiomed. KA is a consultant for Boston Scientific and Liva Nova. WWO is a consultant for Abiomed, Boston Scientific and Edwards. MA has received honorarium from Abiomed. PV, MZ, DDW report no relevant disclosures.

Additional information

Funding

The authors have no funding to report for this paper.