IABP and pVADs: Clinical Effectiveness Versus Cost

By Atman P. Shah, MD, FACC, FSCAI
Clinical Director, Section of Cardiology
Co-Director, Cardiac Catheterization Laboratory
Associate Professor of Medicine
The University of Chicago

Interventional cardiologists are increasingly able to take care of complex coronary artery disease in a population of patients that would have be been deemed too high-risk a decade ago. However, many of these patients have poor left ventricular function and may need to undergo prolonged ischemic times during percutaneous revascularization. There are a number of support devices available for interventional cardiologists to use, and given that every single patient is different, it is up to the operator to personalize therapy within the construct of available data. But, the available data are not entirely clear and do not seem to clearly favor one device over another. Given the changing economics of health care, if there is no clear winning device, should cost influence a physician’s decision? The data published in our article in this month’s Journal of Invasive Cardiology compared the clinical effectiveness of  intraaortic balloon pumps and percutaneous ventricular assist devices, and then compared the cost associated with using each device.
Would patients in cardiogenic shock fare differently with different devices? Does timing of the placement of devices impact outcomes? Further studies with larger databases are necessary to help solve these and other questions.
Read the entire article at:
Shah AP, Retzer EM, Nathan S, et al. Clinical and Economic Effectiveness of Percutaneous Ventricular Assist Devices for High-Risk Patients Undergoing Percutaneous Coronary Intervention. J INVASIVE CARDIOL 2015;27(3):148-154
As well as the accompanying commentary at:
Shields M, Goldberg S. Intraaortic Balloon Pump Versus Percutaneous Ventricular Assist for the High-Risk Patient: Keep it Simple Except When You Can’t. J INVASIVE CARDIOL 2015;27(3):155-156.

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