Temporary support strategies for cardiogenic shock: extracorporeal membrane oxygenation, percutaneous ventricular assist devices and surgically placed extracorporeal ventricular assist devices

Ventricular assist devices for durable support.

Clinical Challenge What can we offer a 70-year-old retired schoolteacher hospitalized with congestion for the third time in 6 months? The LVEF is 21%. Shortness of breath interrupts sleeping and dressing, and peak oxygen consumption of 9 mL/kg per minute confirms NYHA Class IV status. He has noninsulindependent diabetes and chronic coronary artery disease, with patent grafts to thin-caliber ves...

Percutaneous ventricular assist devices: clinical evidence

Efficient therapy of cardiogenic shock and optimal protection in high-risk p ercutaneous coronary intervention are still orphaned to ideal management. Intra-aortic b alloon pump and the newer percutaneous ventricular assist devices, such as TandemHeart and Impella Recover LP 2.5, have diversified the therapeutic arsenal with which one can tackle these clinical dilemmas. This article describes t...

Left Ventricular Assist Devices.

Percutaneous left ventricular assist devices in acute myocardial infarction complicated by cardiogenic shock.

Cardiogenic shock (CS) remains the most common cause of death in patients with acute myocardial infarction (AMI). In addition to percutaneous coronary intervention, inotropes, and fluids, intraaortic balloon pumping (IABP) is most widely used for initial haemodynamic stabilization. However, the main limitation of IABP is the lack of active circulatory support and the requirement of a certain le...

Pediatric ventricular assist devices.

The field of pediatric mechanical circulatory support with ventricular assist devices has lagged significantly behind that of adult patients. However, there is increasing attention on the emerging field of pediatric ventricular assist device support. In this review, part of the Pediatric Cardiac Intensive Care Society/Extracorporeal Life Support Organization Joint Consensus Statement on Mechani...