Options for Advanced Mechanical Support for Cardiogenic Shock Complicating Cardiac Reoperations

摘要: Mechanical cardiac support has had a fascinating development over the past 4 decades. With widespread application of cardiopulmonary bypass (CPB) for interventions, since its first use in 1953 by Dr. Gibbon (AM J Cardiol 12: 399, 1963), and ability to understand potential complications circulatory support, efforts were soon initiated mechanically replace heart simply failing myocardium allow recovery. Because concerns scrutiny initial totally artificial (TAH) 1969 Cooley (Am 24(5): 723–30, 1969), it was not until mid-1980s, with report ventricular assist device (VAD) as bridge transplant Portner (Artif Organs 9: 36, 1985), that mechanical became popular method patients advanced failure. Since then, there been rapid rise number VADs implanted each year, more than 800 VAD implantations – including left devices (LVADs), biventricular (BiVADs), TAHs performed different indications United States 2009 (Interagency Registry Mechanically assisted 2011). The experience patient selection management individual centers contributed this explosive increase but biggest factor contributing increased likely improvements technology, from original reports pulsatile pump use, sophisticated axial flow pumps, lately centrifugal pumps.