June 22, 2007Open Access
View Full PaperPercutaneous left ventricular assist devices in acute myocardial infarction complicated by cardiogenic shock
Structured PICO
Do percutaneous left ventricular assist devices (LVAD) provide beneficial active circulatory support in patients with acute myocardial infarction complicated by cardiogenic shock not responding to standard treatment?
P
Population
Patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS), particularly those with severe depression of LV function not responding to standard treatment including intraaortic balloon pumping (IABP)
I
Intervention
Percutaneous left ventricular assist devices (LVAD) with active circulatory support
This review summarizes the current experience and potential benefits of percutaneous LVADs in patients with AMI complicated by cardiogenic shock who do not respond to standard therapies like IABP.
Abstract
Cardiogenic shock (CS) remains the most common cause of death in patients with acute myocardial infarction (AMI). In addition to percutaneous coronary intervention, inotropes, and fluids, intraaortic balloon pumping (IABP) is most widely used for initial haemodynamic stabilization. However, the main limitation of IABP is the lack of active circulatory support and the requirement of a certain level of left ventricular (LV) function. In many patients with severe depression of LV function, haemodynamic support and LV unloading derived from IABP is insufficient to reverse CS. The use of percutaneous LV assist devices (LVAD) with active circulatory support might be beneficial in CS patients not responding to standard treatment including IABP support. This review reports the current experience of percutaneous LVAD in CS complicating AMI.