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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
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Percutaneous Mechanical Circulatory Support for Cardiogenic Shock
Kevin J Morine1, Navin K Kapur2
1The Cardiovascular Center, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA. nkapur@tuftsmedicalcenter.org.
Current Treatment Options in Cardiovascular Medicine
|January 14, 2016
Summary
Percutaneous, non-durable mechanical circulatory support (MCS) for cardiogenic shock (CS) is increasingly used, but large trials are lacking. Further research is needed to optimize device selection, timing, and management for better patient outcomes.
Area of Science:
- Cardiology
- Critical Care Medicine
- Medical Devices
Background:
- Percutaneous, non-durable mechanical circulatory support (MCS) use is rising for cardiogenic shock (CS).
- Large randomized clinical trials validating MCS benefit in CS are currently unavailable.
- Emerging guidelines address MCS implementation, patient selection, device choice, and post-implantation care.
Purpose of the Study:
- To highlight the need for improved understanding of MCS in cardiogenic shock.
- To identify key areas requiring further investigation for optimizing patient care.
Main Methods:
- This is an opinion statement based on current clinical practice and literature review.
- It synthesizes emerging trends and identifies knowledge gaps in the use of non-durable MCS for CS.
Main Results:
- Distinct hemodynamic effects of various MCS devices require clarification.
- Optimal timing for MCS implementation in specific clinical scenarios needs definition.
- Criteria for identifying "non-salvageable" CS are necessary to guide "no" decisions for MCS.
- Best practices for monitoring, weaning, and metabolic management during MCS use are essential.
Conclusions:
- Enhanced understanding of MCS device hemodynamics, timely implementation, clear criteria for "non-salvageable" CS, and optimized management protocols are crucial.
- These advancements are necessary to improve clinical outcomes for patients with cardiogenic shock requiring MCS.
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