Mechanical circulatory support devices in cardiogenic shock and acute heart failure: current evidence

Abstract

Purpose of review: The main purpose of this review is to highlight and summarize recently published studies on the usage of short-term mechanical circulatory support devices for treatment of cardiogenic shock. Importantly, this review will focus on percutaneously implanted devices.

Recent findings: In recent years, usage of active mechanical circulatory support devices, such as catheter-based left ventricular-assist devices and veno-arterial extracorporeal membrane oxygenation devices, has been widely adopted. Several device-specific strategies have been proposed to improve outcome of treated patients with cardiogenic shock, ranging from early identification and treatment of patients via dedicated shock protocols to combinatory usage of these devices. However, this is not supported by prospective, randomized trials but by retrospective analysis, which are significantly impacted by bias.

Summary: Randomized, controlled trials are utterly needed to guide treatment with mechanical circulatory support for patients with cardiogenic shock. Importantly, such trials should focus patient selection criteria.