A continuous-flow external ventricular assist device for cardiogenic shock: Evolution over 10 years

Abstract Background The use of percutaneous mechanical circulatory support (MCS) in the treatment of cardiogenic shockhas increased. However, limitations in flow capability, ventricular unloading effect, durability, and mobility remain. We reviewed our single-centerexperience with continuous-flow external ventricular assist devices(VADs) to determine the role of temporary VADs for cardiogenic shockin the contemporary MCS era. Methods We retrospectively reviewed 252 patients who underwent continuous-flow external VAD insertion between January 2007 and December 2016. To investigate the change in indications, device configurations, and outcomes, we divided the cohort into 2 groups—2007 to 2011 (Era 1; n = 127) and 2012 to 2016 (Era 2; n = 125)—and compared early and late outcomes. Results Indications and device configurations changed significantly over time. The use of preoperative percutaneous MCS (53% vs 23%; P P P = .04). Overall survival at 1 year was 57% in Era 2 versus 43% in Era 1 ( P = .04). Conclusions Better outcomes in the recent era could be associated with the changes in practice patterns using continuous-flow external VAD in patients with refractory cardiogenic shock.