Ventricular assist devices in acute heart failure

In Western countries, the incidence of acute heart failure has been growing rapidly and is associated with increased incidence of mortality. Acute heart failure encompasses an extended spectrum of clinical presentation. From these, cardiogenic shock remains its most dramatic entity and is burdened by a dismal prognosis. As the initial therapeutic armamentarium (pressor agents, non-invasive or invasive ventilation using positive end-expiratory pressure, treatment of the damaging agent, ultrafiltration and intra-aortic balloon counterpulsation) might be soon overcome, implantation of mechanical ventricular assistance should be considered. Constant technical improvements have allowed quick and percutaneous implantation of such left ventricular assistance devices (LVADs). Herein, we review the technical characteristics and clinical data of the percutaneous LVADs currently available in Europe for treatment of overt cardiogenic shock.