Mechanical Circulatory Support for Advanced Heart Failure

Park, Jin Joo; Cho, Hyun-Jai

doi:2015.88.2.142

Korean J Med > Volume 88(2); 2015 > Article

Special Review

The Korean Journal of Medicine 2015;88(2):142-149.
Published online February 1, 2015.
DOI: https://doi.org/10.3904/kjm.2015.88.2.142

Mechanical Circulatory Support for Advanced Heart Failure

Jin Joo Park¹, Hyun-Jai Cho²

¹Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
²Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea

심부전 환자에서 기계적 순환 보조 장치의 임상적인 역할

박진주¹, 조현재²

^¹분당서울대학교병원 순환기내과
^²서울대학교병원 순환기내과

Correspondence:
Hyun-Jai Cho, Tel: +82-2-2072-3931, Fax: +82-2-3675-0805, Email: hyunjaicho@snu.ac.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Patients with end-stage heart failure or cardiogenic shock experience unacceptably high mortality despite advances in treatment made over the past 50 years. The effects of vasoactive drugs used to manage cardiogenic shock may be limited, being highly dependent on “remaining” heart function. Mechanical circulatory support improves cardiac output independent of heart function. Intra-aortic balloon pumps (IABPs) and extracorporeal membrane oxygenation (ECMO) are the devices most commonly used in Korea. Despite frequent use, the utility of IABPs in acute myocardial patients remains controversial, whereas ECMO affords sufficient systemic perfusion pressure to reverse end-organ dysfunction. Both can only be used as acute treatments, thus as a bridge-to-recovery or a bridge-to-transplantation. Percutaneous left ventricular assist devices (LVADs) such as TandemHeart® and Impella are not in use in Korea. Implanted LVADs improve long-term outcomes and may also serve as destination therapies. In the present manuscript, we briefly review percutaneous and implantable devices currently used in Korea for the management of ad-vanced heart failure.

Key Words: Heart failure; Intra-aortic balloon pumping (IABP); Extracorporeal membrane oxygenation (ECMO); Ventricular assist device (VAD)

주제어: 심부전; 대동맥 내 풍선 펌프; 기계적 순환 보조; 심실 보조 장치