Contemporary Management of Valvular Cardiogenic Shock Using Transcatheter Valve Interventions

Valvular cardiogenic shock is an under-recognized, yet potentially reversible cause of hemodynamic collapse associated with high mortality. Rapid recognition, comprehensive hemodynamic assessment, and multidisciplinary Heart Team management are critical for successful treatment. Surgical intervention is often prohibitive because of hemodynamic instability, advanced comorbidities, prior cardiac surgeries, or multiorgan dysfunction. We report a case series of patients with diverse valvular pathologies presenting with cardiogenic shock who were treated with transcatheter valve interventions, including transcatheter aortic valve replacement, transcatheter edge-to-edge repair, and balloon mitral valvuloplasty. Mechanical circulatory support was individualized according to shock phenotype and ventricular function. Although all procedures achieved technical success with immediate hemodynamic improvement, clinical outcomes varied according to the severity of underlying ventricular dysfunction, right ventricular failure, renal injury, and postcardiotomy physiology.