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. 2014 Nov;3(6):606-11.
doi: 10.3978/j.issn.2225-319X.2014.08.03.

Evolving strategies in the treatment of acute myocardial infarction-induced cardiogenic shock

Vakhtang Tchantchaleishvili  1 , Heidi Schubmehl  1 , Michael F Swartz  1 , William Hallinan  1 , H Todd Massey  1
Affiliations

Evolving strategies in the treatment of acute myocardial infarction-induced cardiogenic shock

Vakhtang Tchantchaleishvili et al. Ann Cardiothorac Surg. 2014 Nov.

Abstract

Despite advances in medical technology and re-vascularization interventions, the mortality rate for cardiogenic shock (CS) following acute myocardial infarction has remained at 50%. The majority of these mortalities are from left ventricular failure resulting in multi-system organ dysfunction. The field of mechanical circulatory support (MCS) has evolved within the past decade, with improved outcomes from extracorporeal membrane oxygenation as well as continuous-flow left ventricular assist devices (CF LVADs). In this paper, we discuss our institutional treatment strategies, the rationale for the protocol development, and our improved outcomes when using MCS in patients with refractory CS following acute myocardial infarction.

Keywords: Cardiogenic shock (CS); acute myocardial infarction; mechanical circulatory support (MCS); ventricular assist device (VAD).

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Figures

Figure 1
Figure 1
Treatment strategy for patients with acute myocardial infarction cardiogenic shock (AMICS). VAD, ventricular assist device; CPR, cardiopulmonary resuscitation; CF VAD, continuous flow ventricular assist device; ECMO, extracorporeal membrane oxygenation.
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