Key result
Temporary LVADs can bridge pregnant patients at risk of cardiac decompensation to cesarean delivery.
Why the study?
Pregnancies with pre-existing heart disease have an increased risk of antenatal and postpartum clinical decompensation due to altered physiologic and hemodynamic demands on the circulatory system.
Case Report (n=2)
Temporary pLVADs can serve as an effective bridge to cesarean delivery for pregnant patients with HFrEF who develop cardiogenic shock in the third trimester.
Answers are grounded in this paper and cite their sources.
May warrant temporary LVAD bridge to cesarean in peripartum cardiogenic shock; extends experience to pregnant HFrEF patients and is hypothesis-generating.
BACKGROUND: Pregnancies associated with pre-existing heart disease are at increased risk for clinical decompensation in the antenatal and postpartum periods given the altered physiologic and hemodynamic demands on the circulatory system that occur during pregnancy. CASE SUMMARY: We describe 2 patients with pre-existing heart failure with reduced ejection fraction (HFrEF) who developed cardiogenic shock during the third trimester and required multidisciplinary clinical evaluation and use of temporary percutaneous left ventricular assist devices (pLVADs) as a support strategy through cesarean delivery. DISCUSSION: Temporary pLVADs are useful in cardiogenic shock during high-risk peripartum periods to manage severe left ventricular noncompliance, hemodynamic changes associated with delivery, operative fluid shifts, and postpartum autotransfusion. TAKE-HOME MESSAGES: Temporary pLVADs serve as an effective bridge to cesarean delivery. Peridelivery cardiovascular risk stratification, optimal employment of temporary pLVADs, and balancing anticoagulation required for temporary LVAD with perioperative bleeding risks are nuanced clinical decisions that require multidisciplinary planning.
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Oosbree et al. (2026) conducted a case report in Peripartum cardiogenic shock with pre-existing HFrEF (n=2). Temporary percutaneous left ventricular assist devices (pLVADs) was evaluated. Temporary percutaneous left ventricular assist devices served as an effective bridge to cesarean delivery in two patients with HFrEF and peripartum cardiogenic shock.
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