[Left ventricular assist devices in cardiogenic shock and chronic refractory heart failure].
Decompensated heart failure, either acute (cardiogenic shock) or chronic (terminal heart failure) may become refractory to conventional therapy, then requiring mechanical assistance of the failing heart to improve hemodynamics. In the acute setting, aortic balloon counterpulsation is used as first line therapy. In case of failure, other techniques include the extracorporal membrane oxygenator or a percutaneous left ventricular assist device, such as the TandemHeart or the Impella. In chronic heart failure, long-term left ventricular assist devices can be surgically implanted. The continuous flow devices give here the best results. The aim of the present review article is to present with some details the various methods of mechanical left ventricle assistance to which the intensivist may be confronted in his daily practice.
Service de médecine intensive adulte et Centre des brûlés, CHUV, 1011 Lausanne. audrey.genton@chuv.ch
Audrey
A
Genton
Roger
R
Hullin
Piergiorgio
P
Tozzi
Stéphane
S
Cook
Lucas
L
Liaudet
D013504:Cardiovascular Surgical Procedures / Q000295:instrumentation / Q000379:methods; D002908:Chronic Disease; D006333:Heart Failure / Q000601:surgery* / Q000628:therapy; D006352:Heart Ventricles / Q000601:surgery*; D006353:Heart-Assist Devices / Q000706:statistics & numerical data*; D006801:Humans; D008954:Models, Biological; D055502:Secondary Prevention; D012770:Shock, Cardiogenic / Q000209:etiology / Q000601:surgery* / Q000628:therapy; D020257:Ventricular Remodeling / Q000502:physiology