Fast Five Quiz: Heart Failure Management

Yasmine S. Ali, MD


September 11, 2019

In general, for patients in acute cardiogenic shock due to heart failure, the 2013 ISHLT guidelines for MCS recommend long-term MCS devices as a bridge-to-transplantation therapy or a destination therapy for patients at high risk for 1-year mortality. In addition, the ISHLT recommendations include reserving long-term MCS for patients in acute cardiogenic shock in whom the following exist:

  • Unrecoverable ventricular function or ventricular function that is not likely to recover without long-term MCS

  • Inability to maintain normal hemodynamics and vital organ function with temporary MCS devices, or inability to be weaned from temporary MCS devices or inotropic support

  • Capacity for meaningful recovery of end-organ function and quality of life

  • Reversible end-organ damage

Per the aforementioned, the ISHLT does not recommend long-term MCS devices for patients in acute cardiogenic shock who have irreversible end-organ damage, who are not inotrope-dependent but whose history is positive for heart failure, or who are able to maintain normal hemodynamics and vital organ function.

For more guidelines and recommendations on the utilization of MCS devices, read here.


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