ABSTRACT
INTRODUCTION Currently, no formal guidelines detail the indications for temporary left ventricular (LV) support. This lack of consensus notwithstanding, short-term mechanical cardiac assistance may be appropriate in a few well-defined circumstances. In the setting of acute myocardial infarction (AMI) with severely compromised ventricular function, temporary mechanical support unloads the left ventricle and augments cardiac output. Unloading the ventricle, particularly when initiated prior to reperfusion, may improve myocardial blood flow and reduces reperfusion injury. Improving cardiac output mitigates endorgan damage potentially limiting the systemic inflammatory response. In the case of chronic heart failure, temporary LV support reverses the acute metabolic derangements associated with decompensation. If the ventricle is able to recover sufficiently, medical management may be resumed. If ventricular function remains inadequate, temporary support may serve as a bridge to more definitive therapy. Finally, during high-risk percutaneous coronary intervention (PCI), temporary support provides circulatory protection in the event of acute vessel closure or catastrophic LV compromise.
