Short-term mechanical circulatory assist devices
- Julian M Aroesty, MD
Julian M Aroesty, MD
- Clinical Associate Professor of Medicine
- Harvard Medical School
- Valluvan Jeevanandam, MD
Valluvan Jeevanandam, MD
- Chief, Cardiac & Thoracic Surgery
- Professor of Surgery
- The University of Chicago Medicine and Biological Sciences
- Howard J Eisen, MD
Howard J Eisen, MD
- Thomas J Vischer Professor of Medicine
- Drexel University College of Medicine
Short-term mechanical circulatory assist (support) devices are designed to be used for a wide range of clinical conditions ranging from prophylactic insertion for high-risk invasive coronary artery procedures to the management of cardiogenic shock, acute decompensated heart failure, or cardiopulmonary arrest. These devices are often placed in the catheterization laboratory but in some cases, such as an intraaortic balloon pump, can be placed in intensive care unit.
There are four major (arbitrary) categories of circulatory assist devices: intraaortic balloon pump (IABP), non-IABP percutaneous mechanical circulatory assist devices (image 1), extracorporeal membrane oxygenator pumps, and nonpercutaneous centrifugal pumps, which are used for cardiopulmonary bypass.
A description of the short-term circulatory assist devices will be reviewed here. The clinical indications for these devices are discussed separately. (See 'Indications' below.)
The role for intermediate- and long-term mechanical circulatory devices as "bridges" to transplantation or as replacement therapy for failing hearts is discussed separately. (See "Intermediate- and long-term mechanical circulatory support".)
MECHANISM OF BENEFIT
While each device discussed below has a different design and operation, the following parameters of circulatory function are improved by all devices; the degree of improvement varies between devices and patients :
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- MECHANISM OF BENEFIT
- NON-IABP PERCUTANEOUS CIRCULATORY DEVICES
- Left ventricle to aorta assist devices
- Left atrial to aorta assist devices
- Other limitations
- EXTRACORPOREAL MEMBRANE OXYGENATION
- NONPERCUTANEOUS CENTRIFUGAL PUMPS