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Updated: Sep 22, 2025

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
06:10

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Published on: June 12, 2021

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Mechanical circulatory support in cardiogenic shock: a critical appraisal

Giulia Masiero1, Francesco Cardaioli1, Giuseppe Tarantini1

  • 1Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua Medical School, Padua, Italy.

Expert Review of Cardiovascular Therapy
|May 19, 2022
PubMed

Insights

Optimal treatment for acute myocardial infarction (AMI) with cardiogenic shock (CS) involves early mechanical circulatory support (MCS) and extensive revascularization, alongside specialized shock teams, to improve survival rates in multivessel coronary artery disease (MVD).

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Critical Care Medicine

Background:

  • Acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) carries a high mortality rate, even with current treatments.
  • Multivessel coronary artery disease (MVD) presents unique challenges in AMI-CS patients.
  • Current guidelines suggest culprit lesion-only (CLO) revascularization in AMI-CS, but this is based on limited evidence.

Purpose of the Study:

  • To review current evidence on optimal revascularization strategies for MVD in patients with AMI-CS.
  • To assess the role of mechanical circulatory support (MCS) devices in managing AMI-CS.
  • To highlight the importance of integrated care approaches, including shock teams and healthcare networks.

Main Methods:

  • In-depth review of existing literature and observational data.
  • Analysis of outcomes related to different revascularization strategies (CLO vs. extensive).
  • Evaluation of the impact of early MCS implantation on patient survival.

Main Results:

  • Emerging evidence suggests early MCS implantation prior to percutaneous coronary intervention (PCI) may improve outcomes.
  • Extensive revascularization, rather than CLO, appears beneficial in select AMI-CS patients.
  • The implementation of dedicated shock teams and coordinated care networks is crucial.

Conclusions:

  • Optimal management of AMI-CS with MVD requires a shift towards early MCS and comprehensive revascularization.
  • Multidisciplinary collaboration and system-level organization are essential for improving survival.
  • Further research is needed to refine treatment guidelines for this high-risk population.
Abstract

Keywords:
Cardiogenic shockacute myocardial infarctionleft ventricular assist devicesmechanical circulatory support

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