TY - JOUR
T1 - Temporary mechanical circulatory support devices
T2 - Updates from recent studies
AU - Marbach, Jeffrey A.
AU - Chweich, Haval
AU - Miyashita, Satoshi
AU - Kapur, Navin K.
N1 - Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.
PY - 2021/7/1
Y1 - 2021/7/1
N2 - Purpose of reviewOver the past several years, the role of short-term mechanical circulatory support (MCS) devices has become the dominant focus in efforts to improve outcomes in patients with cardiogenic shock (CS). Alongside these efforts, temporary MCS devices have been increasingly used to support patients prior to cardiac surgery, during high-risk percutaneous coronary intervention, awaiting cardiac transplantation, and in the setting of refractory cardiac arrest. The present review aims to provide an update on the recent literature evaluating the evolving role of temporary MCS devices, and to provide insights into the current challenges and future directions of MCS research.Recent findingsRecent observational data have demonstrated potential roles for intra-aortic balloon pump preoperatively in high-risk patients awaiting coronary artery bypass grafting, and advanced heart failure patients awaiting transplantation. Impella continues to demonstrate promising results as part of an early MCS strategy in CS, as a temporary bridge to transplantation, and as a mechanism for left ventricular unloading in patients on venoarterial extracorporeal membrane oxygenation (ECMO). Finally, the first randomized trial of ECMO facilitated resuscitation in the United States demonstrated improved survival in patients with refractory out of hospital cardiac arrest.SummaryThough randomized data remains limited, observational data continue to support the role of temporary MCS devices in a variety of clinical settings.
AB - Purpose of reviewOver the past several years, the role of short-term mechanical circulatory support (MCS) devices has become the dominant focus in efforts to improve outcomes in patients with cardiogenic shock (CS). Alongside these efforts, temporary MCS devices have been increasingly used to support patients prior to cardiac surgery, during high-risk percutaneous coronary intervention, awaiting cardiac transplantation, and in the setting of refractory cardiac arrest. The present review aims to provide an update on the recent literature evaluating the evolving role of temporary MCS devices, and to provide insights into the current challenges and future directions of MCS research.Recent findingsRecent observational data have demonstrated potential roles for intra-aortic balloon pump preoperatively in high-risk patients awaiting coronary artery bypass grafting, and advanced heart failure patients awaiting transplantation. Impella continues to demonstrate promising results as part of an early MCS strategy in CS, as a temporary bridge to transplantation, and as a mechanism for left ventricular unloading in patients on venoarterial extracorporeal membrane oxygenation (ECMO). Finally, the first randomized trial of ECMO facilitated resuscitation in the United States demonstrated improved survival in patients with refractory out of hospital cardiac arrest.SummaryThough randomized data remains limited, observational data continue to support the role of temporary MCS devices in a variety of clinical settings.
KW - cardiogenic Shock
KW - impella
KW - intra-aortic balloon pump
KW - mechanical circulatory support
KW - venoarterial extracorporeal membrane oxygenation
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U2 - 10.1097/HCO.0000000000000880
DO - 10.1097/HCO.0000000000000880
M3 - Review article
C2 - 33990478
AN - SCOPUS:85107390455
SN - 0268-4705
VL - 36
SP - 375
EP - 383
JO - Current Opinion in Cardiology
JF - Current Opinion in Cardiology
IS - 4
ER -