An insight into short- and long-term mechanical circulatory support systems

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• 作者：Markus Ferrari (1)
  Peter Kruzliak (2)
  Kyriakos Spiliopoulos (3)
  
  1. Clinic of Internal Medicine 1 ; HSK ; Klinikum der Landeshauptstadt Wiesbaden und der HELIOS Kliniken Gruppe ; Wiesbaden ; Germany
  2. Department of Cardiovascular Diseases ; International Clinical Research Center ; St. Anne鈥檚 University Hospital and Masaryk University ; Pekarska 53 ; Brno ; 656 91 ; Czech Republic
  3. Department of Thoracic and Cardiovacsular Surgery ; School of Medicine ; University of Thessaly ; Larissa ; Greece
  
• 关键词：Mechanical circulatory support systems ; Ventricular assist devices ; Cardiogenic shock ; Cardiac interventions ; Short ; and long ; term use
• 刊名：Clinical Research in Cardiology
• 出版年：2015
• 出版时间：February 2015
• 年：2015
• 卷：104
• 期：2
• 页码：95-111
• 全文大小：1,809 KB
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• 刊物主题：Cardiology;
• 出版者：Springer Berlin Heidelberg
• ISSN：1861-0692

文摘

Cardiogenic shock due to acute myocardial infarction, postcardiotomy syndrome following cardiac surgery, or manifestation of heart failure remains a clinical challenge with high mortality rates, despite ongoing advances in surgical techniques, widespread use of primary percutaneous interventions, and medical treatment. Clinicians have, therefore, turned to mechanical means of circulatory support. At present, a broad range of devices are available, which may be extracorporeal, implantable, or percutaneous; temporary or long term. Although counter pulsation provided by intra-aortic balloon pump (IABP) and comprehensive mechanical support for both the systemic and the pulmonary circulation through extracorporeal membrane oxygenation (ECMO) remain a major tool of acute care in patients with cardiogenic shock, both before and after surgical or percutaneous intervention, the development of devices such as the Impella or the Tandemheart allows less invasive forms of temporary support. On the other hand, concerning mid-, or long-term support, left ventricular assist devices have evolved from a last resort life-saving therapy to a well-established viable alternative for thousands of heart failure patients caused by the shortage of donor organs available for transplantation. The optimal selection of the assist device is based on the initial consideration according to hemodynamic situation, comorbidities, intended time of use and therapeutic options. The present article offers an update on currently available mechanical circulatory support systems (MCSS) for short and long-term use as well as an insight into future perspectives.