Percutaneous transvalvular microaxial flow pump is underused in infarct-related cardiogenic shock: pros and cons

Cardiogenic shock (CS) is among the most feared complications of myocardial infarction and leads to high rates of mortality. Percutaneous transvalvular microaxial flow pumps have emerged as an alternative treatment option in the setting of infarct-related CS, offering an alternative to venoarterial extracorporeal membrane oxygenation (VA-ECMO). The principle behind the use of a percutaneous transvalvular microaxial flow pump is to sustain blood flow in the systemic circulation by pumping blood from the left ventricle to the ascending aorta. However, the use of this device is not exempt from complications, mainly including severe bleeding and peripheral vascular complications. In addition, randomised data on the use of percutaneous transvalvular microaxial flow pumps are limited due to the complexity of the clinical scenario, and the profile of optimal candidates is yet to be defined. Based on current evidence, whether a percutaneous transvalvular microaxial flow pump should be used more in patients presenting with myocardial infarction complicated by CS remains an area of uncertainty