From medical therapy to mechanical support: strategies for device selection and implantation techniques

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Letizia F Bertoldi - , Cardio Center (Author)
  • Andrea Montisci - , Division of Cardiothoracic Intensive Care (Author)
  • Dirk Westermann - , Medical University of Graz (Author)
  • Mario Iannaccone - , San Giovanni Bosco Hospital (Author)
  • Vasileios Panoulas - , Royal Brompton and Harefield Hospitals (Author)
  • Nikos Werner - , Heartcenter Trier (Author)
  • Norman Mangner - , Department of internal Medicine with focus on Cardiology (at Herzzentrum Dresden), University Hospital Carl Gustav Carus Dresden (Author)

Abstract

Cardiogenic shock (CS) is a complex clinical syndrome with a high risk of mortality. The recent, rapid development of temporary mechanical circulatory support (tMCS) has altered CS treatment. While catecholamines remain the cornerstone of CS therapy, tMCS usage has increased. According to shock severity, different treatment strategies including catecholamines alone, catecholamines and tMCS, or multiple tMCS might be used. State-of-the-art implantation techniques are necessary to avoid complications linked to the invasive nature of tMCS. In particular, bleeding and access-site complications might counteract the potential haemodynamic benefit of a percutaneous ventricular assist device. In this review, we describe the role of catecholamines in CS treatment and present the different tMCS devices with an explanation on how to use them according to CS aetiology and severity. Finally, an overview of the best practice for device implantation is provided.

Details

Original languageEnglish
Pages (from-to)I11-I18
JournalEuropean Heart Journal, Supplement
Volume25
Issue numberSuppl I
Publication statusPublished - Dec 2023
Peer-reviewedYes

External IDs

PubMedCentral PMC10715943
Scopus 85180325854

Keywords