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Temporary Circulatory Support With Ventricular Assist Devices: Update on Surgical and Percutaneous Strategies

  • Cardiogenic Shock: Progress in Mechanical Circulatory Support (JE Rame, Section Editor)
  • Published:
Current Heart Failure Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The available platforms for temporary circulatory support (TCS) have expanded to include impeller technologies in addition to the traditional approaches with centrifugal pumps and intra-aortic counterpulsation. We review the evidence for competing technologies, relative risk, and benefit of individual TCS platforms and provide a consensus opinion in the context of our institutional experience.

Recent Findings

Trans-aortic axial flow devices (Impella) have significantly impacted the support of patients with cardiogenic shock. Despite the absence of prospective randomized data, the use of both percutaneous and surgical Impella devices is ubiquitous among heart failure centers and rapidly evolving. Extracorporeal centrifugal pumps remain the technology of last resort.

Summary

Despite the increasing use of new TCS platforms, there is little empirical evidence that outcomes have been impacted. Increasingly, systems of care—rather than technology—are seen as the more important variable in the management of patients with cardiogenic shock.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Department of Cardiothoracic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA

    Enrique Gongora, Erik Orozco & Charles Hoopes

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  1. Enrique Gongora
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  2. Erik Orozco
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Correspondence to Charles Hoopes.

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Gongora, E., Orozco, E. & Hoopes, C. Temporary Circulatory Support With Ventricular Assist Devices: Update on Surgical and Percutaneous Strategies. Curr Heart Fail Rep 17, 350–356 (2020). https://doi.org/10.1007/s11897-020-00491-x

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