92970 Cardioassist-method of circulatory assist; internal

Name of the Procedure:

Cardioassist-method of circulatory assist; internal (also known as Intra-aortic Balloon Pump (IABP) or Ventricular Assist Device (VAD) insertion).

Summary

Cardioassist is an internal circulatory assist procedure designed to support the heart's pumping function. In simple terms, it involves inserting a device that helps the heart pump blood more effectively, improving blood flow throughout the body.

Purpose

The procedure aims to help patients with severe heart failure or those recovering from a heart attack. The goal is to improve heart function, increase blood flow, and reduce the heart's workload.

Indications

Cardioassist may be indicated for:

• Severe heart failure.
• Cardiogenic shock.
• Post-heart attack recovery.
• Pre or post high-risk cardiac surgeries. Patients suitable for this procedure typically have conditions compromising their heart's ability to pump blood effectively.

Preparation

• Patients may need to fast for several hours before the procedure.
• Specific medications may need adjustment or temporary cessation.
• Diagnostic tests such as ECG, blood tests, and imaging studies are usually required to assess heart function and overall health status.

Procedure Description

1. The patient is administered local or general anesthesia.
2. A catheter is inserted into a blood vessel (typically in the groin or chest).
3. A specialized device, such as an intra-aortic balloon pump or ventricular assist device, is guided to the heart.
4. The device is carefully positioned to assist in the heart’s pumping actions.
5. Once in place, the device is activated to help the heart pump blood more effectively.
6. Continuous monitoring ensures the device's proper functioning and patient safety.

Duration

The procedure typically takes between 1-2 hours.

Setting

The procedure is usually performed in a hospital catheterization lab or cardiac surgery suite.

Personnel

The team usually includes:

• Cardiologist or cardiothoracic surgeon.
• Anesthesiologist.
• Surgical nurses.
• Cardiovascular technologists.

Risks and Complications

Common risks include infection, bleeding, and blood vessel damage. Rare but serious complications can include device malfunction, stroke, or heart attack. Proper management strategies are in place to address these issues if they arise.

Benefits

The main benefit is improved heart function and enhanced blood flow. Patients can typically expect to notice symptomatic relief and increased physical capabilities within days to weeks.

Recovery

• Patients usually stay in the hospital for a few days for monitoring and initial recovery.
• Post-procedure care involves wound care, medication adjustments, and activity restrictions.
• Follow-up appointments are essential to monitor heart function and device performance.

Alternatives

Alternatives can include:

• Medication management (e.g., diuretics, inotropes).
• Percutaneous coronary interventions (e.g., angioplasty).
• Heart transplant in severe cases. Each alternative has its own advantages and disadvantages depending on the patient's specific condition and overall health.

Patient Experience

Patients may feel some discomfort during the catheter insertion but should not feel pain after the anesthesia takes effect. Post-procedure, patients may experience soreness at the insertion site, but pain can be managed with medications. Regular follow-up ensures the patient is adjusting well and that the device functions properly.