Next Generation Temporary Mechanical Circulatory Support for Cardiogenic Shock

Cardiogenic shock remains the leading cause of death in patients with acute myocardial infarction and severe acute heart failure. Temporary mechanical circulatory support devices have emerged as important adjuncts for restoring systemic perfusion, unloading the failing ventricle, and stabilizing patients for cardiogenic shock and during high-risk percutaneous coronary interventions. However, currently available devices are associated with important limitations, including vascular complications, hemolysis, and uncertain survival benefit. Technological innovation has led to the development of new percutaneous mechanical support systems designed to deliver higher cardiac output with more limited vascular access and improved hemocompatibility. This review summarizes the current evidence regarding current and emerging temporary mechanical circulatory support devices used in cardiogenic shock and high-risk percutaneous coronary interventions. Literature from major clinical trials, observational registries, and device development studies was reviewed to evaluate device mechanisms, hemodynamic performance, and emerging technologies.