Hemodynamic and functional criteria for circulatory support in acute heart failure (cardiogenic shock)

Circulatory support devices are frequently required in postcardiotomy shock, post-myocardial infarction shock and acute myocarditis. The implantation of a ventricular assist device preserves the lives of patients with life-threatening cardiogenic shock and leads to recovery from secondary organ failure. Patient selection for mechanical assist devices therapy is the most important step in obtaining a successful outcome. Numerous risk factors impact on the outcome, many of which can be identified and treated before device surgery. Assessing the risk of this therapy requires evaluating the degree of organ dysfunction and technical factors. Patients should be offered the option of ventricular assist therapy if they meet criteria for requirement, potential for organ recovery, and present an appropriate operative risk.