How Would the Authors Treat Their Own Temporary Left Ventricular Failure With Mechanical Circulatory Support?

In the last 20 years, mechanical circulatory supports (MCS) have overturned completely the outcomes and the clinical recovery of patients with isolated acute left ventricle failure (iALVF). This usually occurs more frequently than right-sided heart failure or biventricular dysfunction, and it mainly...

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Bibliographic Details
Published in:Journal of cardiothoracic and vascular anesthesia 2022-05, Vol.36 (5), p.1238-1250
Main Authors: Loforte, Antonio, Comentale, Giuseppe, Botta, Luca, Gliozzi, Gregorio, Cavalli, Giulio Giovanni, Mariani, Carlo, Pilato, Emanuele, Suarez, Sofia Martin, Pacini, Davide
Format: Article
Language:English
Subjects:
ECMO
Extracorporeal Membrane Oxygenation - adverse effects
Heart Failure - etiology
Heart Failure - surgery
Heart Transplantation - adverse effects
Heart-Assist Devices - adverse effects
Humans
IABP
Impella
Intra-Aortic Balloon Pumping - adverse effects
left heart failure
mechanical circulatory support
Shock, Cardiogenic - etiology
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Summary:In the last 20 years, mechanical circulatory supports (MCS) have overturned completely the outcomes and the clinical recovery of patients with isolated acute left ventricle failure (iALVF). This usually occurs more frequently than right-sided heart failure or biventricular dysfunction, and it mainly is caused by acute myocardial infarction. The primary role of MCS is to restore the tissue metabolism to preserve the vital organs’ function but, on the other hand, they also have to relieve the workload stress on the heart. In this way, they allow not only the heart to recover from the acute event, but MCS also can stabilize the patient toward cardiac transplantation. The short-term MCS devices currently used in clinical practice are the intraaortic balloon pump, the Impella (Abiomed, Danvers, MA), and venoarterial extracorporeal membrane oxygenation (VA-ECMO), but the choice of the right and tailored device for each patient, as well as the timing to use it, is actually one of the most debated topics of MCS management.
ISSN:1053-0770
1532-8422
DOI:10.1053/j.jvca.2021.10.020