Mechanical circulatory support in cardiogenic shock.

PURPOSE OF REVIEW: Cardiogenic shock remains a complex clinical syndrome with high morbidity and mortality. The purpose of this article is to review important landmark trials as well as the relevant recent literature for percutaneous mechanical circulatory support following acute myocardial infarction.

RECENT FINDINGS: The sole use of intraaortic balloon pumps for cardiogenic shock following acute myocardial infarction continues to be questioned with downgrading of its recommendation in recent years, there however may remain a role in patients with mechanical complications of their myocardial infarction. The combined use of extracorporeal circulatory support and a ventricular unloading device appears to be promising with increasing data supporting this strategy.

SUMMARY: Given the complex and heterogeneous nature of cardiogenic shock there remains somewhat limited robust data to guide clinical practice. Ongoing research is needed to help guide improvements in patient outcomes.