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The New Era of Cardiogenic Shock: Progress in Mechanical Circulatory Support

  • 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

In recent decades, multiple left and right ventricular assist devices (VAD) have been developed, and the utilization of these devices has grown exponentially. We discuss the most common temporary mechanical circulatory support (tMCS) devices used for patients in cardiogenic shock, including the intra-aortic balloon pump (IABP), transvalvular axial flow support systems (Impella®), the Tandem™ collection, and extracorporeal membrane oxygenation (ECMO).

Recent Findings

In 2018 the United Network for Organ Sharing (UNOS) introduced new listing criteria for candidates awaiting heart transplantation in the USA. Analysis of the first 1300 transplants under these new listing criteria has shown that higher-risk patients are now undergoing transplantation.

Summary

As technology has advanced, becoming more sophisticated and miniaturized, a new era has emerged with more rapidly deployable tMCS devices. For some patients presenting in cardiogenic shock, support with these tMCS devices can be a bridge to a more durable option. For others, their only option may be support with the hope of native cardiac recovery. Understanding the pros and cons of each device can lead to most appropriate utilization for the ultimate intended goal.

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Abbreviations

IABP:

Intra-aortic balloon pump

ECMO:

Extracorporeal membrane oxygenation

tMCS:

Temporary mechanical support

LV:

Left ventricle

VAD:

Ventricular assist device

CS:

Cardiogenic shock

PCI:

Percutaneous coronary intervention

AMI:

Acute myocardial infarction

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

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Authors and Affiliations

  1. Center for Advanced Heart and Lung Diseases, Baylor University Medical Center, 3410 Worth Street, Suite 250, Dallas, TX, 75246, USA

    Ahmed Seliem & Shelley A. Hall

  2. Division of Cardiology, Baylor University Medical Center, Baylor Scott & White Health, Dallas, TX, USA

    Shelley A. Hall

  3. Texas A&M University Health Science Center College of Medicine, Dallas, TX, USA

    Shelley A. Hall

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  1. Ahmed Seliem
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Correspondence to Ahmed Seliem.

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Dr. Hall is a consultant for Abiomed, Abbott Laboratories, Syncardia, and Evaheart. Dr. Seliem has no potential conflicts of interest relevant to this article.

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Seliem, A., Hall, S.A. The New Era of Cardiogenic Shock: Progress in Mechanical Circulatory Support. Curr Heart Fail Rep 17, 325–332 (2020). https://doi.org/10.1007/s11897-020-00490-y

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