Introduction Cardiogenic shock (CS) is characterized by hypotension (systolic blood pressure [SBP] 90 mmHg) despite adequate filling pressures, accompanied by clinical and biochemical signs of systemic hypoperfusion.1 Early recognition and treatment of CS is critical to prevent irreversible organ damage and death.2 The most common underlying etiology of CS is acute myocardial infarction (MI) with left ventricular dysfunction, which accounts for up to 80% of cases,1,3 and in France in 2015 an estimated 3% of acute MIs were complicated by CS.4 There is a high unmet need for effective interventions for patients with CS; it remains the most common cause of in-hospital mortality in patients hospitalized for MI,1 with reported rates of in-hospital mortality in CS patients ranging from 4050% at 1 month but up to 70% for patients with refractory CS.5 Pharmacologic intervention with inotropes or vasopressors is generally advocated as a first-line treatment option;6 however, 1520% of patients with CS are refractory to pharmacologic treatment.7 Mechanical circulatory support (MCS) devices represent a critical and increasingly widely used component in the management of patients with refractory CS. Temporary MCS devices serve as a bridge to recovery, the placement of a durable MCS or heart transplantation. Continue reading
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