Mechanical circulatory support in postoperative cardiogenic shock

A 38-year-old white woman had cardiogenic shock after elective mitral valve replacement and was unresponsive to pressor drugs and intra-aortic balloon counterpulsation. A left ventricular assist device (left ventricle to ascending aorta) was implanted 16 hours after the initial operation and provided circulatory support for 8 days. Improvement in the patient's own cardiac performance was documented, and there were no complications attributable to the assist device. However, intercurrent medical problems resulted in clinical deterioration on the fifth day after operation, and the patient died 8 days after operation. The findings in this patient suggest a potential role for this left ventricular assist device in future cases of acute, intractable, but potentially reversible myocardial failure.