Short- and long-term mechanical cardiac assistance

With the increase in high risk patients undergoing cardiac surgery and the substantial mortality among patients waiting for cardiac transplantation, t he need for mechanical circulatory support is growing. Several devices are currently available, ranging from the intra-aortic balloon pump to fully im plantable ventricular assist devices. Each system has ifs own features, and proper patient selection as well as the timing of implantation is sometime s difficult. Algorithms for stepwise management in subgroups of patients re main controversial and the concepts of weaning patients after myocardial re covery during mechanical circulatory support need further evaluation for th eir long-term effects. Future identification of valuable prognostic and ris k factors may help in decision-making and allow for improved survival of th ese often very ill patients. In this report we review the concepts of mecha nical circulatory support at our institution with emphasis on a detailed ov erview of technical features of extracorporeal life support.