title: Percutaneous Mechanical Circulatory Support for Cardiogenic Shock.
abstract: The use of percutaneous, non-durable mechanical circulatory support (MCS) for cardiogenic shock (CS) is growing; however, large, randomized clinical trials confirming benefit in this population do not exist. Guidelines and recommendations regarding optimal timing for MCS implementation, patient selection, device selection, and post-implantation management are beginning to emerge. A better understanding of (1) the distinct hemodynamic effects of each device option, (2) the need for early implementation of the appropriate device option for a particular clinical scenario, (3) the definition of non-salvageable CS to help clinicians know when to say "no" to non-durable MCS, and (4) best practices to monitor, wean, and optimize metabolic parameters while using non-durable MCS are required to continue improving clinical outcomes for patients with CS.
authors.affiliation: The Cardiovascular Center, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA. nkapur@tuftsmedicalcenter.org.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Morine
authors.affiliation: The Cardiovascular Center, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA.
authors.forename: Navin K
authors.initials: NK
authors.lastname: Kapur
keywords: Cardiogenic shock; ECMO; Heart failure; Impella; Percutaneous mechanical support; TandemHeart