Use of the Percutaneous Left Ventricular Assist Device in Patients with Severe Refractory Cardiogenic Shock as a Bridge to Long-term Left Ventricular Assist Device Implantation

Temporary Left Ventricular Assist Device Through an Axillary Access is a Promising Approach to Improve Outcomes in Refractory Cardiogenic Shock Patients

“…To evaluate the TandemHeart, one study including 117 patients demonstrated 30 day and 6 month mortality rates of 40.2% and 45.3% after percutaneous VAD therapy, which was inferior to our outcomes. 2,21 During their short-term support, the TandemHeart group also had improved hemodynamic and biological parameters. However, several complications were reported, including a femoral artery dissection, groin hematomas, bleeding at the cannula site, limb ischemia, and high infection rates.…”

“…However, several complications were reported, including a femoral artery dissection, groin hematomas, bleeding at the cannula site, limb ischemia, and high infection rates. 2,21 Therefore, temporary LVAD by an axillary approach is equivalent or superior to other available mechanical support devices.…”

A stepwise progression in the treatment of cardiogenic shock

“…16,17 In addition, observational studies looking at the TandemHeart in patients with intractable cardiogenic shock refractory to IABP and vasopressor support have demonstrated improvements in patients' hemodynamics and offer promise from a mortality standpoint in terms of its use as a bridge to more definitive therapy. 18,19 However, further prospective randomized trials are needed for a more comprehensive evaluation regarding the role of percutaneous ventricular assist device support in this high-risk patient population.…”

New Insights in the Management of Cardiogenic Shock Complicating Myocardial Infarction: Role of Urgent Heart Transplantation

“…18 In countries where the donor rate is much lower and waiting times are longer, strategies promoting the use of VADs, percutaneous left VADs, or extracorporeal membrane oxygenation could be applicable. 19,20,21 Prior data suggest that urgent HTx might have poorer short-term and long-term outcomes than elective HTx. Experience in our institution, however, disagrees with this concept: In a series of 97 patients who underwent elective HTx, the mortality rate at 30 days, which was 12.4%, was comparable with the mortality rate in patients who underwent urgent HTx and with the mortality rate observed in the present study.…”