Mechanical support for postcardiotomy cardiogenic shock: has progress been made?
Postcardiotomy cardiogenic shock (PCCS) complicates 0.2% to 6% of cardiac operations and is a clinical entity fraught with considerable morbidity and mortality. A previous review of this topic by our group suggested that regardless of device, only 25% of patients survived to hospital discharge. In the interim, newer technologies have entered the clinical arena. Additional contributions have been made to the literature and new databases are collecting data that are likely to provide more robust guidance for the management of these very complex patients. In this review, we update the experience of mechanical support in the PCCS patient and provide a strategy to maximize survival for a patient who develops PCCS in the community cardiac surgery center.
Sylvin
Erik A
EA
Montefiore-Einstein Heart Center, Albert Einstein College of Medicine, Bronx, New York 10467, USA.
Stern
David R
DR
Goldstein
Daniel J
DJ
D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000295:instrumentation; D002316:Cardiotonic Agents / Q000627:therapeutic use; D004867:Equipment Design; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation; D006353:Heart-Assist Devices; D006801:Humans; D006835:Hydrazones / Q000627:therapeutic use; D009518:New York; D011183:Postoperative Complications / Q000601:surgery*; D011724:Pyridazines / Q000627:therapeutic use; D012770:Shock, Cardiogenic / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D000077464:Simendan; D013997:Time Factors
D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan