Role of acute mechanical circulatory support devices in cardiogenic shock

Abstract

Cardiogenic shock is a state of low cardiac output that is associated with significant morbidity and mortality. A considerable proportion of patients with cardiogenic shock respond poorly to medical management and require acute mechanical circulatory support (AMCS) devices to improve tissue perfusion as well as to support the heart. In the last two decades, many new AMCS devices have been introduced to support the right, left, and both ventricles. All these devices vary in terms of the support they provide to the body and heart, mechanism of functioning, method of insertion, and adverse events. In this review, we compare and contrast the available percutaneous and surgically placed AMCS devices used in cardiogenic shock and discuss the associated clinical and hemodynamic data to make a conscious decision about choosing a device.

PlasmaBlade-assisted surgical septal myectomy: technique and our experience

“…Another surgeon in our institution has been able to perform septal myectomy using the PlasmaBlade after observing and cross-scrubbing for five cases. We believe that the use of the PlasmaBlade in other surgical procedures, e.g., pacemaker pocket creation, axillary artery exposure for Impella 5.5 or intra-aortic balloon pump insertion, and pericardiectomy, may increase the comfort level of the surgeon in using the PlasmaBlade and may shorten his learning curve during septal myectomy ( 24 – 26 ). However, our assertion needs further verification with a greater number of surgeons and a larger number of patients.…”