RT Book, Section A1 McGee, Edwin C. A1 Moazami, Nader A2 Cohn, Lawrence H. SR Print(0) ID 55916135 T1 Chapter 18. Temporary Mechanical Circulatory Support T2 Cardiac Surgery in the Adult, 4e YR 2012 FD 2012 PB The McGraw-Hill Companies PP New York, NY SN 978-0-07-163310-9 LK accesssurgery.mhmedical.com/content.aspx?aid=55916135 RD 2024/10/10 AB A number of ventricular assist devices (VADs) are available for acute circulatory support. As opposed to long-term VADs, which are designed for bridge to transplantation or long-term support in the nontransplant patient, temporary VADs are designed to reestablish adequate organ perfusion rapidly. Patients in cardiogenic shock require early aggressive therapy. Despite relief of ischemia, inotropic drugs, and control of cardiac rhythm, some patients remain hemodynamically unstable and require some type of mechanical circulatory support in order to restore a normal cardiac output. Cardiogenic shock occurs in 2.4 to 12% of patients with acute myocardial infarction (AMI).1 The Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock (SHOCK) trial demonstrated mortality of greater than 50% despite revascularization.2 If instituted promptly, temporary mechanical support potentially leads to improved survival in this group of patients.3 The need for circulatory support in the postcardiotomy period is relatively low and has been estimated to be in the range of 0.2 to 0.6%,4 but when it occurs, it needs to be managed effectively if the patient is to be salvaged. Additional indications for acute VADs are in chronic heart failure patients who suffer cardiovascular collapse, and severe cases of myocarditis and postpartum cardiomyopathy.