Percutaneous Valvuloplasty in Cardiogenic Shock

Cardiogenic shock is far less frequently caused by valvular disease than by coronary disease or cardiomyopathies. For two main reasons, however, assessment of the treatment of cardiogenic shock in patients with valvular disease is of interest. First, the frequency of valvular disease remains high in both developing and industrialized countries even though the etiologies are different (1). Second, until the early 1980s, surgery was the only possible treatment, but the introduction of percutaneous techniques has reoriented the treatment of valvular stenoses (2,3). This led to an expectation that the minimally invasive nature of percutaneous techniques would make them more suited to patients with cardiogenic shock than surgery, which carries a very high risk as a result of the advanced stage of the disease and the urgent nature of the interventions.