Thiele Holger, Smalling Richard W, Schuler Gerhard C
Department of Internal Medicine/Cardiology, University of Leipzig--Heart Center, Strümpellstr. 39, 04289 Leipzig, Germany.
Eur Heart J. 2007 Sep;28(17):2057-63. doi: 10.1093/eurheartj/ehm191. Epub 2007 Jun 22.
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.
心源性休克（CS）仍然是急性心肌梗死（AMI）患者最常见的死亡原因。除了经皮冠状动脉介入治疗、使用血管活性药物和补液外，主动脉内球囊反搏（IABP）是最广泛用于初始血流动力学稳定的方法。然而，IABP的主要局限性在于缺乏主动循环支持，并且需要一定水平的左心室（LV）功能。在许多左心室功能严重受损的患者中，IABP提供的血流动力学支持和左心室负荷减轻不足以逆转CS。对于对包括IABP支持在内的标准治疗无反应的CS患者，使用具有主动循环支持的经皮左心室辅助装置（LVAD）可能有益。本综述报告了经皮LVAD在并发AMI的CS中的当前应用经验。
