How Would the Authors Treat Their Own Temporary Left Ventricular Failure With Mechanical Circulatory Support

Abstract In the last twenty years, mechanical circulatory supports (MCS) have completely overturned the outcomes and the clinical recovery of patients with isolated acute left ventricle failure (iALVF). This usually occurs more frequently than the right-sided heart failure or than the biventricular disfunction, and it is mainly caused by the acute myocardial infarction. The primary role of MCS is to restore the tissue metabolism in order to preserve the vital organs’ function but, on the other hand, they also have to relieve the workload stress on the heart. In this way, they allow not only the heart to recover from the acute event, but MCS can also stabilize the patient towards cardiac transplantation (HTx). The short-term MCS devices currently used in clinical practice are the intra-aortic balloon pump (IABP), the Impella (Abiomed, Danvers, MA, USA) and the Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO), but the choice of the right and “tailored” device for each patient, as well as the timing to use it, is actually one of the most debated topics of the MCS management. We herein describe and compare indications, outcomes, and technical features of IABP, Impella and VA-ECMO, as treatment of iALVF.