Introduction
Postcardiotomy cardiogenic shock (PCCS), defined by inadequate end-organ perfusion due to low cardiac output, occurs after 1-5% of cardiac surgical procedures, and in about 1% of cases, patients may require postoperative mechanical circulatory support (MCS).1,2The typical presentation of PCCS is decreasing cardiac function along with the difficulty or inability to wean from cardiopulmonary bypass without high-dose inotropic support and/or advanced MCS. Current MCS strategies include the use of intra-aortic balloon (IABP) counterpulsation, extracorporeal membrane oxygenation (ECMO), percutaneously-implanted or surgically implanted left ventricular assist devices, or a combination of devices.1 Despite advances in the development of support strategies, in-hospital mortality following PCCS remains high, with reports ranging from 40-90%.3–10
Due to the high costs of MCS usage following PCCS, along with the propensity for increased rates of further complication, prolonged intensive care and hospital stays, and ultimately high rate of death, it is often debated whether these measures are beneficial or futile. Furthermore, the long-term outcomes in survivors of PCCS have not been well-studied. Therefore, this study aimed to investigate our experience in using de novo MCS for PCCS following cardiac surgery, and examine short and long-term outcomes.