Routine Early ECLS in Infarct-Related Cardiogenic Shock?

The 30-day mortality among patients with an acute myocardial infarction complicated by cardiogenic shock who undergo coronary-artery revascularization procedures approaches 50% in contemporary clinical trials and registries.(1) In patients with persistent hemodynamic compromise and organ hypoperfusion despite resuscitative measures, mechanical circulatory support may improve both systemic and myocardial perfusion, reduce ventricular workload, and provide periprocedural support for percutaneous coronary intervention (PCI).(2) Among the available percutaneous devices, extracorporeal life support (ECLS) with venoarterial extracorporeal membrane oxygenation provides complete cardiopulmonary circulatory support and manages refractory respiratory failure. Despite its increasing use in patients with myocardial infarction and cardiogenic shock, data regarding the . . .