Utilization and Outcomes of Temporary Percutaneous Right Ventricular Assist Devices in Cardiogenic Shock

Acute right ventricular failure (RVF) is a common finding in cardiogenic shock (CS), yet the optimal method of supporting the failing RV remains unclear. This study aimed to describe CS patients receiving percutaneous right ventricular assist devices (pRVADs) using the multicenter Cardiogenic Shock Working Group (CSWG) registry. Among 6,201 patients with CS, 152 (2.4%) received pRVADs, with ProtekDuo and Impella RP being used in 71% and 29% of cases, respectively. The average age of this group was 58.5 years, with a higher proportion of men (66.4%). Heart failure-associated CS (HF-CS) was observed in 48% of patients, while myocardial infarction-associated CS (MI-CS) was seen in 27% (HF-CS versus MI-CS: 52.8% vs. 21.3% for ProtekDuo; 36.4% vs. 40.9% for Impella RP; p = 0.01). The overall in-hospital mortality rate was 54.6%, bleeding complications were more prevalent among ProtekDuo recipients (64.8% vs. 43.2%, p = 0.008), whereas Impella RP recipients had shorter hospital stays (20.4 ± 18.7 vs. 41.9 ± 31.5 days, p < 0.001). ProtekDuo was more commonly used in patients with HF-CS and was associated with higher rates of bleeding and longer hospital stays compared with Impella RP, although overall mortality was similar. Further investigation is required to determine the ideal timing and clinical conditions warranting pRVAD deployment in CS.