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Update on mechanical circulatory support

ESC Congress Report

  • Combination of IABP and ECMO may be useful
  • Early referral is essential in LVAD candidates
  • Right ventricular assessment is difficult, yet important


View the Slides from this session in ESC Congress 365

This session provided a fascinating insight into the evolving world of mechanical circulatory support in extreme cardiogenic shock.

It began with an overview from Professor Leprince regarding the temporary devices currently available for the full range of potential clinical scenarios in the acute setting, including the emerging use of ECMO and EMCO-CPR. The important finding that concomitant IABP+ECMO offloads the LV was discussed, suggesting it be routine for peripheral ECMO.

Professor Jessup focused on the use of isolated LVAD in patients with cardiogenic shock, outlining some of the classifications and definitions which clincians involved in VADs are required to utilize, highlighting the importance of early referral, as well as the critical requirement for concomitant right ventricular assessment. Adverse outcomes from VAD were discussed, reiterating the superior outcome from transplantation compared with any currently available mechanical device. 

Professor Potapov described the importance and challenges regarding acute and ongoing RV assessment in the era of modern continuous flow devices, as well as treatment options in the context of persistent biventricular failure. The overriding message from all three initial speakers was of the importance of timely and appropriate assessment and referral.

Finally, Professor Carpentier described his 30-year collaborative enterprise, leading to the evolution of the first bioprosthetic totally implantable heart, with the first implantation in a human subject as part of a preliminary study occurring in 2013. Professor Carpentier ended his presentation by paying homage to patients who participate in such innovative clinical trials, describing them as the “real heroes of medical progress”.

References


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SessionTitle:

Update on mechanical circulatory support

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.