The various perioperative issues of structural heart diseases and cardiogenic shock

Curr Probl Cardiol. 2024 Aug;49(8):102646. doi: 10.1016/j.cpcardiol.2024.102646. Epub 2024 May 30.

Abstract

Up to 20 % of patients presenting with acute heart failure and cardiogenic shock have a structural etiology. Despite efforts in timely management, mortality rates remain alarmingly high, ranging from 50 % to 80 %. Surgical intervention is often the definitive treatment for structural heart disease; however, many patients are considered high risk or unsuitable candidates for such procedures. Consequently, there has been a paradigm shift towards the development of novel percutaneous management strategies and temporizing interventions. This article aims to provide a comprehensive review of the pathophysiology of valvular and structural heart conditions presenting in cardiogenic shock, focusing on the evolving landscape of mechanical circulatory support devices and other management modalities.

Keywords: Mechanical circulatory support; Shock; Valvular disease.

Publication types

  • Review

MeSH terms

  • Cardiac Surgical Procedures / adverse effects
  • Cardiac Surgical Procedures / methods
  • Heart Diseases
  • Heart Failure / physiopathology
  • Heart Failure / surgery
  • Heart Failure / therapy
  • Heart-Assist Devices*
  • Humans
  • Perioperative Care / methods
  • Shock, Cardiogenic* / etiology
  • Shock, Cardiogenic* / therapy