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Options for Advanced Mechanical Support for Cardiogenic Shock Complicating Cardiac Reoperations

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Redo Cardiac Surgery in Adults

Abstract

Mechanical cardiac support has had a fascinating development over the past 4 decades. With the widespread application of cardiopulmonary bypass (CPB) for cardiac interventions, since its first use in 1953 by Dr. Gibbon (AM J Cardiol 12: 399, 1963), and the ability to understand the potential and complications of circulatory support, efforts were soon initiated to mechanically replace the heart and to simply support the failing myocardium to allow recovery. Because of the concerns and scrutiny of the initial use of a totally artificial heart (TAH) in 1969 by Dr. Cooley (Am J Cardiol 24(5): 723–30, 1969), it was not until the mid-1980s, with the first report of the use of a ventricular assist device (VAD) as bridge to transplant by Dr. Portner (Artif Organs 9: 36, 1985), that mechanical support became a popular method to assist patients with advanced heart failure. Since then, there has been a rapid rise in the number of VADs implanted each year, with more than 800 VAD implantations – including left ventricular assist devices (LVADs), biventricular assist devices (BiVADs), and TAHs – performed for different indications in the United States in 2009 (Interagency Registry for Mechanically assisted circulatory support, 2011). The experience in patient selection and management of individual centers has contributed to this explosive increase in VAD use but the biggest factor contributing to increased VAD use has likely been the improvements in VAD technology, from the original reports of pulsatile pump use, to the more sophisticated axial flow pumps, and lately centrifugal flow pumps.

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Authors and Affiliations

  1. Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Christian Bermudez MD, Kenji Minakata MD & Robert L. Kormos MD

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  1. Christian Bermudez MD
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  2. Kenji Minakata MD
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  3. Robert L. Kormos MD
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Correspondence to Christian Bermudez MD .

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Editors and Affiliations

  1. Centre Ave 5200, Pittsburgh, 15232-1300, Pennsylvania, USA

    V.R. Machiraju

  2. , Division of Cardiovascular Surgery, Mayo Clinic, First Street SW 200, Rochester, 55905, Minnesota, USA

    Hartzell V. Schaff

  3. , Department of Thoracic and Cardiovascula, Cleveland Clinic Foundation, Euclid Avenue 9500, Cleveland, 44195, Ohio, USA

    Lars G. Svensson

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Bermudez, C., Minakata, K., Kormos, R.L. (2012). Options for Advanced Mechanical Support for Cardiogenic Shock Complicating Cardiac Reoperations. In: Machiraju, V., Schaff, H., Svensson, L. (eds) Redo Cardiac Surgery in Adults. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1326-4_9

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  • DOI: https://doi.org/10.1007/978-1-4614-1326-4_9

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