Percutaneous support of the failing left and right ventricle-recommendations for the use of mechanical device therapy

Heart Fail Rev. 2018 Nov;23(6):831-839. doi: 10.1007/s10741-018-9730-z.

Abstract

Patients in cardiogenic shock and acute heart failure show high mortality and morbidity despite aggressive and invasive methods such as percutaneous coronary intervention and the use of mechanical support devices. Percutaneous implantation of active hemodynamic support is often the only option for hemodynamic stabilization of patients in cardiogenic shock. Therefore, current guidelines support the use of these devices. Standardized protocols and clinical algorithms for the use of these support devices decrease mortality in these patients. The aim of this review is an overview of current therapies of cardiogenic shock with special focus on mechanical support devices and the suggestion of a clinical algorithm for the differential use of current devices as well as the hemodynamic monitoring of such patients in order to reduce mortality in cardiogenic shock.

Keywords: Heart failure; Mechanical support; Shock.

Publication types

  • Review

MeSH terms

  • Extracorporeal Membrane Oxygenation
  • Heart Failure / complications
  • Heart Failure / physiopathology
  • Heart Failure / therapy*
  • Heart Ventricles / physiopathology*
  • Heart-Assist Devices*
  • Humans
  • Intra-Aortic Balloon Pumping*
  • Risk Factors
  • Shock, Cardiogenic / etiology
  • Shock, Cardiogenic / therapy*
  • Ventricular Function, Left / physiology*
  • Ventricular Function, Right / physiology*