Percutaneous left ventricular assist devices for treatment of patients with cardiogenic shock

Windecker, Stephan (2007). Percutaneous left ventricular assist devices for treatment of patients with cardiogenic shock. Current opinion in critical care, 13(5), pp. 521-7. Hagerstown, Md.: Lippincott Williams & Wilkins 10.1097/MCC.0b013e3282efd5bc

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PURPOSE OF REVIEW: This review will discuss the rationale and clinical utility of percutaneous left ventricular assist devices in the management of patients with cardiogenic shock. RECENT FINDINGS: Left ventricular assist devices maintain partial or total circulatory support in case of severe left ventricular failure. Currently, two percutaneous left ventricular assist devices are available for clinical use: the TandemHeart and the Impella Recover LP system. Compared with the intraaortic balloon pump, the TandemHeart has been shown to significantly reduce preload and to augment cardiac output. In a randomized comparison between the TandemHeart and intraaortic balloon pump support in patients with cardiogenic shock, the improved cardiac index afforded by the left ventricular assist device resulted in a more rapid decrease in serum lactate and improved renal function. There were, however, no significant differences with respect to 30-day mortality, and complications including limb ischemia and severe bleeding were more frequent with left ventricular assist devices than intraaortic balloon pump support. SUMMARY: The advent of percutaneous left ventricular assist devices constitutes an important advance in the management of patients with severe cardiogenic shock and may serve as bridge to recovery or heart transplantation in carefully selected patients. While improvement of hemodynamic parameters appears promising, it remains to be determined whether this benefit translates into improved clinical outcome.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Windecker, Stephan

ISSN:

1070-5295

ISBN:

17762230

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:00

Last Modified:

05 Dec 2022 14:18

Publisher DOI:

10.1097/MCC.0b013e3282efd5bc

PubMed ID:

17762230

Web of Science ID:

000249514000010

URI:

https://boris.unibe.ch/id/eprint/26151 (FactScience: 65974)

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