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Portable (short-term) mechanical circulatory support 

Portable (short-term) mechanical circulatory support
Chapter:
Portable (short-term) mechanical circulatory support
Author(s):

Susanna Price

and Pascal Vranckx

DOI:
10.1093/med/9780199687039.003.0030_update_002

Update:

Added new Figure 30.6; revised “Right-sided circulatory failure” and “Right ventricular support”

Updated on 22 February 2018. The previous version of this content can be found here.
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date: 20 October 2019

Mechanical circulatory support can be used to resuscitate patients, as a stabilizing measure for angiography and prompt revascularization, or to buy time until more definite measures can be taken. In addition, there is experimental evidence that ventricular unloading of the left ventricle can significantly reduce the infarct size. Different systems for mechanical circulatory support are available to the medical community. Treatment options for mechanical circulatory support must be tailored to each patient in order to maximize the potential benefits and minimize the risk of detrimental effects. Intra-aortic balloon pumping is still the most widely used mechanical circulatory support therapy. The relative ease and speed with which this device can be applied to patients with a rapidly deteriorating haemodynamic picture have led to its widespread use as a first-line intervention among critically unstable patients. Where intra-aortic balloon pumping is inadequate, an immediate triage to a more advanced percutaneous (short-term) mechanical circulatory support may be warranted. Despite their extensive use, the utility of mechanical circulatory support devices in acute heart failure syndromes and cardiogenic shock remains uncertain. This chapter concentrates on the application of mechanical circulatory support relevant to the interventional cardiologist and cardiac intensive care physician.

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