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• W2044291279 abstract "Elective implantation of mechanical cardiac assist devices (MCAD) for end-stage heart failure facilitates recovery of end-organ dysfunction and gives optimal results for bridge to transplantation.1 Unfortunately, many patients are in extremis when finally referred for transplantation.2 Emergency MCAD implantation increases the risk of poor outcome and decreases the rate of success.3,4 Because of increased costs and decreased effectiveness,5 the use of MCADs in emergency situations remains controversial. The decision to undertake MCAD implantation in such emergent conditions is rendered particularly difficult because of a number of concerns. These include the uncertainties of end-organ recovery, the potential for response to conventional therapy, and the necessity of committing a large amount of resources with no assurance of favorable outcome. Even if superior results with MCAD use are obtained in the case of non-emergent implantation, it seems unreasonable to reserve mechanical devices for such indications.6 Patients in cardiogenic shock have few alternatives between death and cardiac support. In such circumstances, we can either avoid treating high-risk patients to obtain good results, thereby excluding potential survivors, or treat more patients but have a higher mortality rate and less uncertainty about whether to treat. In this article, we examine the various elements of this important problem." @default.
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• W2044291279 date "2000-08-01" @default.
• W2044291279 modified "2023-09-27" @default.
• W2044291279 title "Emergency mechanical circulatory support: still viable?" @default.
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• W2044291279 doi "https://doi.org/10.1016/s1053-2498(00)00108-x" @default.
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