Mechanical Circulatory Support Therapies: Right Timing and Prognosis Considerations

Abstract

Timing and prognosis considerations are of crucial importance for success of both short-and long-term mechanical circulatory support. In short-term support, the acute circumstances and severity of cardiogenic shock are key for the prognosis; the longer the support time, the more important the general health situation of the patient becomes. For short-as well as long-term support, strategies are better defined for the failing left ventricle. In most cases the right ventricular function is preserved or improves after mechanical support of the left ventricle. However, ongoing chronic or acute right ventricular impairment and consecutively impaired renal and hepatic function are well-established risk factors for long-term support; frailty becomes more and more important.