Mechanical Circulatory Support: When and How to Use It

Purpose of review The goal of this review is to provide the reader with a summary of the percutaneous mechanical circulatory support (MCS) devices currently used in clinical practice. Recent findings Although there are limited data for MCS including intra-aortic balloon pump (IABP), percutaneous left ventricular (LV) micro-axial pump (Impella), percutaneous left ventricular (LV) centrifugal pump (TandemHeart), VA-extracorporeal membrane oxygenation (VA-ECMO), and right ventricular (RV) support (Impella RP, Protek Duo), these devices are frequently employed in clinical practice. Guidelines largely support the use of MCS in refractory ischemic and non-ischemic cardiogenic shock (CS). However, the literature to support MCS use is limited, especially in the setting of high-risk PCI. Ongoing randomized clinical trials of these devices will help to provide supportive data for MCS utilization in various clinical settings.