Objectives: To document the real-world experience with the use of pneumatic pulsatile mechanical circulatory support (MCS) with the PulseCath iVAC2L during high-risk percutaneous coronary interventions (HR-PCIs). Background: The use of MCS in HR-PCIs may reduce the rate of major adverse cardiovascular events (MACEs) at 90 days. The PulseCath iVAC2L is a short-term pulsatile transaortic left ventricular (LV) assist device that has been in use since 2014. The iVAC2L Registry tracks its safety and efficacy in a variety of hospitals worldwide. Methods: The iVAC2L Registry is a multicenter, observational registry that aggregates clinical data from patients treated with the iVAC2L worldwide. A total of 293 consecutive cases were retrospectively collected and analyzed. Estimated rates of in-hospital clinical endpoints were described. All-cause mortality was used as the primary endpoint and other outcomes of interest were used as secondary endpoints. The rates obtained were reported and contextualized. Results: The in-hospital rate of all-cause mortality was 1.0%, MACE was 3.1%. Severe hypotension occurred in 8.9% of patients. Major bleeding and major vascular complications occurred in 1.0% and 2.1%, respectively. Acute myocardial infarction occurred in 0.7% of patients. Cerebrovascular events occurred in 1.4% of patients. Cardiac arrest occurred in 1.7% of patients. A statistically significant improvement in blood pressure was observed with iVAC2L activation. Conclusions: The results of the present study suggest that the iVAC2L is capable of improving hemodynamics with a low rate of adverse events. However, confirmatory studies are needed to validate these findings.

Background/Objectives: Cardiovascular diseases are the most prevalent comorbidities in patients with acromegaly (APs). Acromegalic cardiomyopathy is the leading cause of mortality in APs. This study aimed to assess changes in morphology and function of the left heart in naïve APs 12 months after the beginning of acromegaly treatment and to explore the effects of disease activity and body composition parameters on changes in the left heart. Methods: This prospective study involved 34 APs and 34 healthy controls (CON) matched for age, gender, and BMI. DXA and 2D echocardiography were performed at diagnosis and 12 months after the beginning of the treatment. Results: In APs, the prevalence of left ventricular (LV) hypertrophy was 70%. LV mass index (LVMI) was greater in APs compared to CON (124 vs. 86 ± g/m², p < 0.001), but with no difference in size and systolic function of the LV. APs presented with increased left atrium volume (LAVI) and with diastolic dysfunction of the LV. Twelve months after the beginning of acromegaly treatment, IGF-1 levels decreased significantly (p < 0.001), and biochemical control of disease was achieved in 73.52% of APs. We found that in all APs, LAVI and LVMI decreased (all p < 0.05), and diastolic function of the LV improved without changes in systolic function. In multiple analyses, the changes in body surface area (β = −0.444, p < 0.001) and in lean body mass (β = −0.298, p = 0.027) were independent predictors of reverse remodelling of LVMI after the treatment. Conclusions: This study confirmed remodelling reversal of the left heart structure, followed by an improvement in diastolic function in naïve APs 12 months after the beginning of acromegaly treatment.

Aims: This study aimed to compare 6‐month survival and complication rates of patients undergoing high‐risk percutaneous coronary intervention (PCI) supported by either iVAC2L mechanical circulatory support (MCS) or intra‐aortic balloon pump (IABP). Methods and Results: In this retrospective cohort analysis, we included 54 patients who underwent a high‐risk PCI for an unprotected left main, 3‐vessel disease or a last remaining vessel stenosis with temporary MCS. Patients received either iVAC2L ( n = 24) or IABP ( n = 30) during PCI. The primary endpoint was 6‐month all‐cause mortality. Secondary endpoints included vascular complications, repeat revascularization, and stroke. The groups had similar baseline characteristics, with the ejection fraction being 34.4 ± 9.5% in the iVAC2L group and 37.9 ± 9.4% in the IABP group ( p = 0.177). The 6‐month mortality rate was lower in the iVAC2L group (8.3%) compared to the IABP group (16.7%), though the difference was not statistically significant ( p = 0.365). Access site vascular complications were numerically higher in the iVAC2L group (12.5% vs. 3.3%; p = 0.201). Repeat revascularization rates (iVAC2L 4.2% vs. IABP 6.7%, p = 0.690) and stroke rates (iVAC2L 4.2% vs. IABP 3.3%, p = 0.872) were similar in both groups. Conclusion: Patients with iVAC2L MCS had higher 6‐month survival compared to IABP in high‐risk PCI, albeit without statistically significant differences. Both devices provided effective hemodynamic support during the intervention with no periprocedural mortality. Vascular complications were numerically more frequent with iVAC2L, highlighting the need for skilled vascular access management. Larger prospective studies are needed to confirm these findings and guide optimal MCS device selection for high‐risk PCI.