Future Directions in Temporary Mechanical Circulatory Support for Cardiogenic Shock: Novel Devices and Evolving Therapeutic Paradigms.

Temporary mechanical circulatory support (tMCS) is the mainstay of therapy for advanced cardiogenic shock (CS). Recent trial data have shown the benefit of microaxial flow pumps in selected cases of acute myocardial infarction with CS; however, inconsistencies exist in the historical data and rates of vascular complications remain unacceptably high. Novel form factors, device miniaturization, new mechanisms of pumping, and design features aimed at mitigating complications, have all become focal points of device innovation. Reliability, ability to provide high levels of circulatory support, durability, and ease of operation/maintenance will ultimately determine the viability of new tMCS devices entering clinical use.