Resumo

HERNANDEZ, Maximiliano. Ventricular assist devices in post-infarction cardiogenic shock. Importance of hemodynamic support. Case report. Rev.Urug.Cardiol. [online]. 2022, vol.37, n.1, e705.  Epub 01-Dez-2022. ISSN 0797-0048.  https://doi.org/10.29277/cardio.37.1.16.

Post-infarction cardiogenic shock characterized by a state of systemic circulatory failure requires early treatment in order to restore hemodynamic stability and ventricular function. This consists of coronary reperfusion through myocardial revascularization, requiring in some cases the use of ventricular assist devices. Veno-arterial ECMO is an extracorporeal circulation system that allows biventricular support by oxygenating the blood and reintroducing it through a continuous flow towards the systemic arterial circulation.

The use of this device in patients with cardiogenic shock has shown a significant improvement in survival at 30 days compared to the use of intra-aortic balloon pump. However, its potential complications, such as difficulty in left ventricular emptying, Harlequin syndrome, bleeding and infections, make the training and teamwork of the heart team essential. A great percentage of these patients will present a severe permanent ventricular dysfunction, so they could be candidates for long-term mechanical circulatory support devices like Heartmate III as a bridge to transplant or myocardial recovery, or destination therapy, which has shown satisfactory results with excellent medium-term survival.

Palavras-chave : acute myocardial infarction; cardiogenic shock; ECMO; Heartmate III; ventricular assist devices.

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