August 5, 2026 · Journal of the American College of Cardiology · DOI: 10.1016/j.jacc.2026.06.041

Impact of Left Ventricular Unloading on Hemodynamics and Stunning in Complex PCI: A CHIP-BCIS3 Substudy

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This study aimed to determine whether elective left ventricular (LV) unloading using a microaxial flow pump (mAFP) during high-risk percutaneous coronary intervention (PCI) could reduce hemodynamic instability and myocardial stunning in patients with severe LV systolic dysfunction. The results indicated that while mAFP reduced the need for inotropes, it was associated with a higher incidence of loss of pulse pressure and did not prevent myocardial stunning. Overall, the findings suggest that LV unloading may not provide the anticipated benefits in this patient population.

Saad M Ezad, Matthew Ryan, Sohail Q Khan, Vasileios F Panoulas, Andrew Ladwiniec, Thomas Keeble, Ian Webb, Aadil Shaukhat, Jonathan Hinton, Matthew E Li Kam Wa, Aish Sinha, Holly Morgan, Kalpa De Silva, Antonis Pavlidis, James Spratt, Thomas Johnson, Simon Walsh, Adrian P Banning, David Hildick-Smith, Peter O'Kane, Nicholas Barrett, Matthew Dodd, Abdel Douiri, Tim Clayton, Divaka Perera, CHIP-BCIS3 Investigators

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Impact of Left Ventricular Unloading on Hemodynamics and Stunning in Complex PCI: A CHIP-BCIS3 Substudy

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