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European Heart Journal Advance Access originally published online on June 22, 2007
European Heart Journal 2007 28(17):2057-2063; doi:10.1093/eurheartj/ehm191
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Percutaneous left ventricular assist devices in acute myocardial infarction complicated by cardiogenic shock

Holger Thiele1,*, Richard W. Smalling2 and Gerhard C. Schuler1

1 Department of Internal Medicine/Cardiology, University of Leipzig—Heart Center, Strümpellstr. 39, 04289 Leipzig, Germany
2 Division of Cardiovascular Medicine, Department of Internal Medicine, The Memorial Hermann Heart and Vascular Institute, University of Texas, Houston, TX, USA

Received 8 November 2006; revised 4 April 2007; accepted 13 April 2007; online publish-ahead-of-print 22 July 2007.

* Corresponding author. Tel: +49 341 8651426/1428; fax: +49 341 865 1461. E-mail address: thielh{at}medizin.uni-leipzig.de

Cardiogenic shock (CS) remains the most common cause of death in patients with acute myocardial infarction (AMI). In addition to percutaneous coronary intervention, inotropes, and fluids, intraaortic balloon pumping (IABP) is most widely used for initial haemodynamic stabilization. However, the main limitation of IABP is the lack of active circulatory support and the requirement of a certain level of left ventricular (LV) function. In many patients with severe depression of LV function, haemodynamic support and LV unloading derived from IABP is insufficient to reverse CS. The use of percutaneous LV assist devices (LVAD) with active circulatory support might be beneficial in CS patients not responding to standard treatment including IABP support. This review reports the current experience of percutaneous LVAD in CS complicating AMI.

Key Words: Shock • Heart-assist device • Heart failure • Haemodynamics • Myocardial infarction


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