ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Are mechanical assist devices life-saving in acute cardiogenic shock?
Gökçen Orhan1, Evren Müge Taşdemir Mete1, Murat Sargın1, Türkan Kudsioğlu2, Sevinç Bayer Erdoğan1, Tolga Sinan Güvenç3, Serap Aykut Aka1
1Dr. Siyami Ersek Gögüs Kalp ve Damar Cerrahisi Egitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, İstanbul, Türkiye
2Dr. Siyami Ersek Gögüs Kalp ve Damar Cerrahisi Egitim ve Araştırma Hastanesi, Anestezi ve Reanimasyon Kliniği, İstanbul, Türkiye
3Dr. Siyami Ersek Gögüs Kalp ve Damar Cerrahisi Egitim ve Araştırma Hastanesi, Kardiyoloji Klinigi, İstanbul, Türkiye
DOI : 10.5606/tgkdc.dergisi.2016.12713
Background: This study aims to investigate the effect of mechanical assist devices on the prevention of low cardiac output and ischemia of organs in patients with cardiogenic shock.

Methods: Between January 2013 and November 2015, a total of 28 patients (18 males, 10 females; mean age 37.3±9.9 years; range 13 to 62 years) with acute cardiogenic shock who were managed with a long-term assist device based on the indication of short-term mechanical assist device in our center were retrospectively analyzed. Demographic, etiological, operative, and postoperative data of the patients were recorded. Extracorporeal membrane oxygenation or Centrimag was implanted as a mechanical assist device.

Results: Of the patients, 14 underwent an intervention for post-cardiac surgery cardiogenic shock, four for acute myocarditis, two for postpartum cardiomyopathy, and eight for acute exacerbation of chronic heart failure. The mean body mass index was 25±2.6 kg/m2. The survival rate of postcardiotomy patients was 28.5%. One of two survivors who were implanted a mechanical assist device for acute myocarditis underwent a long-term left ventricular assist system, while myocardial recovery was observed in the other patient. Out of eight patients with an Intermacs Level 1 underwent longterm assist system, while another patient underwent heart transplantation. The survival rate of this patient group was 25%. The mean utilization times of extracorporeal membrane oxygenation and Centrimag devices were 21±6 days and 27±4 days, respectively.

Conclusion: Our study results show that, irrespective of etiology, short-term application of mechanical assist devices may improve cardiac output in cardiogenic shock patients who are refractory to medical treatment and increase survival in patients undergoing early implantation without any endorgan damage.

Keywords : Acute cardiogenic shock; bridge therapy; mechanical assist device
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