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Updated: Apr 10, 2026

Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
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Trajectories and outcomes in patients with cardiogenic shock receiving heart replacement therapies

Van-Khue Ton1, Qiuyue Kong2, Manreet Kanwar3

  • 1The Mass General Brigham Heart and Vascular Institute, Massachusetts General Hospital, Boston, MA.

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|April 8, 2026
PubMed

Insights

Heart replacement therapy (HRT) in cardiogenic shock (CS) patients is linked to better survival despite higher complications. Further research is needed to identify robust predictors for post-HRT outcomes in CS.

Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Transplantation

Background:

  • Limited data exists on the trajectories of cardiogenic shock (CS) patients undergoing heart replacement therapies (HRT).
  • This study compares CS patients who received HRT versus those who did not during their index CS hospitalization.

Purpose of the Study:

  • To compare the characteristics and outcomes of CS patients receiving HRT versus no HRT.
  • To identify factors associated with survival and mortality in CS patients undergoing HRT.

Main Methods:

  • Retrospective analysis of the Cardiogenic Shock Working Group (CSWG) registry (2021-2024).
  • CS severity assessed using CSWG definitions of Society for Cardiovascular Angiography and Interventions (SCAI) stages, machine learning-derived phenotypes, and the Comorbidity Risk Index for CS (COMRI-CS).
  • Propensity score matching was used to compare outcomes between HRT and no-HRT cohorts.

Main Results:

  • 15.3% of 7,750 CS patients received HRT; HRT recipients were younger and more likely to have heart failure-related CS.
  • HRT recipients had less severe CS (fewer SCAI stage E, less phenotype III) and lower comorbidity burden (lower COMRI-CS risk).
  • Despite higher complication rates, HRT was associated with significantly improved survival (OR 0.11, p<0.001) in a matched cohort, while complications predicted death (OR 2.0, p<0.001).

Conclusions:

  • CS patients receiving HRT demonstrated better clinical profiles and lower mortality, even with increased complications.
  • HRT is associated with improved survival in CS patients.
  • There is a need for robust risk predictors for post-HRT outcomes in CS patients.
Abstract

Keywords:
Cardiogenic shockHeart replacement therapiesHeart transplantLeft ventricular assist deviceMortality

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