Left ventricular functional recovery after complex high-risk indicated percutaneous coronary intervention supported with microaxial flow pump

BACKGROUND: The potential clinical benefit of complex high-risk indicated percutaneous coronary intervention (CHIP-PCI) remains uncertain. Temporary mechanical circulatory support with a microaxial flow pump allows the performance of protected PCI, potentially reducing peri-procedural myocardial injury and enabling a more complete myocardial revascularization. Whether this reflects an improvement in left ventricular (LV) function after PCI remains uncertain. METHODS: We conducted a systematic literature search in PubMed/MEDLINE, Scopus and CENTRAL and performed a one-group meta-analysis using pre- and post-PCI LV ejection fraction (LVEF) data from randomized and observational studies evaluating microaxial flow pump use in CHIP-PCI. The primary outcome was the mean difference (MD) in LVEF between follow-up and baseline. RESULTS: Nine studies involving 2370 patients were included, with a weighted follow-up period of 154.6 days. Overall, 67.4% of patients had chronic coronary syndrome as the clinical presentation, with a mean SYNTAX score of 32.8 and a mean baseline LVEF of 29.5%. CHIP-PCI assisted by a microaxial flow pump was associated with a significant improvement in LVEF during follow-up (MD, +6.70%; 95% confidence interval, 4.49 to 8.91, P = 0.0001). CONCLUSIONS: Microaxial flow pump-supported CHIP-PCI was associated with significant LVEF increase at follow-up, suggesting its potential beneficial role in LV functional recovery after myocardial revascularization in CHIP patients.