title: Hemodynamic support with percutaneous devices in patients with heart failure.
abstract: The use of surgically implanted durable mechanical circulatory support (MCS) in high-risk patients with heart failure is declining and short-term, nondurable MCS device use is growing. Percutaneously delivered MCS options for advanced heart failure include the intra-aortic balloon pump, Impella axial flow catheter, TandemHeart centrifugal pump, and venoarterial extracorporeal membrane oxygenation. Nondurable MCS devices have unique implantation characteristics and hemodynamic effects. Algorithms and guidelines for optimal nondurable MCS device selection do not exist. Emerging technologies and applications will address the need for improved left ventricular unloading using lower-profile devices, longer-term ambulatory support, and the potential for myocardial recovery.
authors.affiliation: The Cardiovascular Center, Tufts Medical Center, 800 Washington Street, BOX 80, Boston, MA 02111, USA. Electronic address: nkapur@tuftsmedicalcenter.org.
authors.forename: Navin K
authors.initials: NK
authors.lastname: Kapur
authors.affiliation: The Cardiovascular Center, Tufts Medical Center, 800 Washington Street, BOX 80, Boston, MA 02111, USA.
authors.forename: Michele
authors.initials: M
authors.lastname: Esposito
mesh_terms: D001243:Assisted Circulation / Q000295:instrumentation / Q000379:methods; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation / Q000379:methods; D006301:Health Services Needs and Demand; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D006352:Heart Ventricles / Q000503:physiopathology; D006353:Heart-Assist Devices; D006439:Hemodynamics; D006801:Humans; D012770:Shock, Cardiogenic / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D016277:Ventricular Function, Left
keywords: Assist device; Cardiogenic shock; Decompensated heart failure; ECMO; Impella; Percutaneous mechanical support; Refractory heart failure; TandemHeart