Journal
HEART FAILURE CLINICS
Volume 11, Issue 2, Pages 215-+Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.hfc.2014.12.012
Keywords
Percutaneous mechanical support; Impella; TandemHeart; ECMO; Cardiogenic shock; Refractory heart failure; Decompensated heart failure; Assist device
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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, Tandem-Heart 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.
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