Mechanical circulatory support for acute heart failure in 2013: an update on available devices, indications and results

Severe acute heart failure often requires some form of mechanical support to circulation. The use of intraaortic balloon counterpulsation in postinfarction cardiogenic shock - perhaps the most common scenario of this kind - has been recently questioned in the IABP SHOCK trial. In the most severe forms, extracorporeal membrane oxygenation is becoming the mainstay of treatment to support circulation or in order to gain time for a further evaluation. Moreover, advances in technology and a reducing number of donors are leading to more extended indications to the implantation of ventricular assist devices. Herein, we offer a focused review on recent articles dealing with mechanical support to circulation in acute heart failure, which we found relevant in terms of their possible impact on therapeutic strategies and indication.