Revascularization in Heart Failure: The Role of Percutaneous Coronary Intervention

Despite being technically challenging and carrying a higher periprocedural risk, the performance of revascularization in patients who have heart failure of ischemic origin can provide substantial clinical benefits. Although several studies have demonstrated a benefit of the performance of coronary artery bypass grafting over percutaneous coronary intervention (PCI) among patients who have depressed ejection fraction undergoing revascularization, most of these studies were conducted during the balloon angioplasty era and before the widespread use of drug-eluting stents that have dramatically reduced the need for repeat revascularization among patients undergoing PCI. The use of lower profile intra-aortic balloon catheters and other novel cardiac support devices may extend the use of PCI and lower rates of periprocedural complications among this high-risk population.