Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Purpose Of Review: Temporary circulatory support (TCS) devices play a crucial role in stabilizing patients with refractory cardiogenic shock. They provide essential hemodynamic support and serve as a bridge to recovery, decision-making, heart transplantation, or long-term mechanical circulatory support. However, despite their increasing use, recent trials challenge their impact on survival. This review summarizes recent findings and discusses challenges in optimizing patient selection and device use.
Recent Findings: The intra-aortic balloon pump (IABP) remains the most used TCS device. However, evidence suggests it is ineffective as a standalone therapy. Its value may lie in combination strategies, such as pairing with VA-ECMO, to enhance ventricular unloading. Recent randomized trials on VA-ECMO, including ECLS-SHOCK, have been disappointing. They show no survival benefit in acute myocardial infarction-related cardiogenic shock. Even well conducted trials face limitations, including heterogeneous patient populations and challenges in endpoint selection, making definitive conclusions difficult. The Impella device showed promising results in the DanGer Shock trial, with reduced mortality compared to standard care. However, concerns persist about patient selection and the unexpectedly high mortality rate in the control group. Meanwhile, the role of temporary right ventricular assist devices is increasingly recognized, particularly in facilitating hemodynamic stability during left ventricular assist device implantation.
Summary: TCS has revolutionized the management of cardiogenic shock, but significant challenges remain. Further research is needed to refine patient selection, improve device integration, and optimize outcomes. Emerging technologies, including biocompatible materials and artificial intelligence for device monitoring, hold promise for advancing the field. Future studies should also prioritize multicenter collaborations and real-world data to address current limitations in evidence.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/MCC.0000000000001282 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Transcatheter edge-to-edge repair for the management of secondary mitral regurgitation - CRT 2025 Beyond the Guidelines.
Cardiovasc Revasc Med
August 2025
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. Electronic address:
Secondary mitral regurgitation (SMR) remains a prevalent and challenging complication in patients with heart failure (HF), associated with poor prognosis despite optimal guideline-directed medical therapy (GDMT) and cardiac resynchronization therapy. Current American and European guidelines recommend GDMT as first-line therapy, with transcatheter edge-to-edge repair (TEER) reserved for severe symptomatic SMR patients who remain refractory. However, both guidelines preceded the reporting of pivotal randomized controlled trials (RESHAPE-HF2, MATTERHORN, and EFFORT) and emerging evidence in new clinical scenarios.
View Article and Find Full Text PDFST-Segment Elevation Myocardial Infarction and Coronary Artery Pseudoaneurysm.
JACC Case Rep
September 2025
Department of Radiology, Gaziantep City Hospital, Gaziantep, Turkey.
Background: Coronary artery pseudoaneurysms (CAP) are rare, especially without any history of coronary angioplasty and coronary bypass graft. The symptoms range from asymptomatic to cardiogenic shock. Because of its rarity and variable symptoms, patients with CAP should be treated with an individualized approach.
View Article and Find Full Text PDFEmergency Heart Transplantation for Recurrent Infective Endocarditis With Irreparable Damage: A Case Beyond Conventional Surgery.
JACC Case Rep
September 2025
Department of Cardiac Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. Electronic address:
Background: Infective endocarditis (IE) with irreversible structural damage has high mortality despite conventional surgery. Heart transplantation (HTx) remains underused in active IE owing to guideline limitations and historical contraindications.
Case Summary: A 61-year-old man with recurrent prosthetic valve IE (aortic/tricuspid vegetations, perivalvular abscesses, and coronary embolism) developed cardiogenic shock.
Fulminant Influenza A Myocarditis in a Healthy Young Adult Salvaged With Biventricular Impella Support: A Case Report.
Cureus
August 2025
Internal Medicine, Baptist Memorial Hospital-North Mississippi, Oxford, USA.
Fulminant myocarditis is a rare but life-threatening complication of influenza A infection that can result in acute biventricular failure leading to cardiogenic shock. Here, we present the case of a young patient who developed acute bilateral heart failure secondary to influenza A and was successfully stabilized using both right and left-sided Impella devices. This case highlights the critical role of early and aggressive mechanical circulatory support (MCS) in managing fulminant myocarditis and emphasizes the utility of Impella in cases of severe cardiac dysfunction.
View Article and Find Full Text PDFAge-related differences in cardiogenic shock secondary to Takotsubo syndrome.
Eur J Clin Invest
September 2025
Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
Background: Age-related differences in Takotsubo Syndrome (TTS) have been described, but there is limited information regarding TTS patients who develop cardiogenic shock (CS).
Methods And Results: We analysed data from 408 CS-TTS patients in the RETAKO registry. Patients were stratified into three age groups: ≤50 years (9%), 51-74 years (48%), and ≥75 years (43%).