ABSTRACT
The foundation of modern mechanical circulatory support (MCS) dates to the first use of cardiopulmonary bypass for open heart surgery in the 1950s. A spectrum of MCS devices exists, ranging from temporary percutaneous support for patients in cardiogenic shock to long-term surgically implanted devices for patients with advanced heart failure. Temporary MCS devices provide a range of hemodynamic support through different mechanisms, augmenting cardiac output and maintaining end organ perfusion. Due to the significant morbidity and mortality associated with advanced heart failure, durable MCS has become an increasingly important therapy. The acuity of patients being considered for MCS is classified according to the Intermacs profiles, ranging from profile 7, an ambulatory patient with New York Heart Class III symptoms, to profile 1 representing critical cardiogenic shock. The landscape of temporary MCS requires efforts to better define which patients derive the most benefit and the optimal timing to initiate these therapies.
