Advancements in mechanical circulatory support for patients in acute and chronic heart failure

Thomas A. Csepe, Ahmet Kilic

Research output: Contribution to journalReview articlepeer-review

17 Scopus citations

Abstract

Cardiogenic shock (CS) continues to have high mortality and morbidity despite advances in pharmacological, mechanical, and reperfusion approaches to treatment. When CS is refractory to medical therapy, percutaneous mechanical circulatory support (MCS) should be considered. Acute MCS devices, ranging from intra-aortic balloon pumps (IABPs) to percutaneous temporary ventricular assist devices (VAD) to extracorporeal membrane oxygenation (ECMO), can aid, restore, or maintain appropriate tissue perfusion before the development of irreversible end-organ damage. Technology has improved patient survival to recovery from CS, but in patients whom cardiac recovery does not occur, acute MCS can be effectively utilized as a bridge to long-term MCS devices and/or heart transplantation. Heart transplantation has been limited by donor heart availability, leading to a greater role of left ventricular assist device (LVAD) support. In patients with biventricular failure that are ineligible for LVAD implantation, further advancements in the total artificial heart (TAH) may allow for improved survival compared to medical therapy alone. In this review, we discuss the current state of acute and durable MCS, ongoing advances in LVADs and TAH devices, improved methods of durable MCS implantation and patient selection, and future MCS developments in this dynamic field that may allow for optimization of HF treatment.

Original languageEnglish (US)
Pages (from-to)4070-4083
Number of pages14
JournalJournal of Thoracic Disease
Volume9
Issue number10
DOIs
StatePublished - Oct 1 2017
Externally publishedYes

Keywords

  • Cardiogenic shock (CS)
  • Heart failure
  • Left ventricular assist device (LVAD)
  • Mechanical circulatory support (MCS)

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Fingerprint

Dive into the research topics of 'Advancements in mechanical circulatory support for patients in acute and chronic heart failure'. Together they form a unique fingerprint.

Cite this