Introduction
Cardiogenic shock is a critical state defined by decreased cardiac
output and impaired end-organ perfusion1–3. Typically
originating from an initial cardiac insult, the process often generates
a systemic cascade resulting in inflammation, cardiac ischemia, and
further impairment of cardiac function4,5. Despite
years of study and advances in technology, the mortality associated with
cardiogenic shock has remained remarkably high6,7.
Most treatment options of the cardiogenic shock state focus on the
support of hemodynamics with the goal of optimizing end-organ
perfusion3,8,9. These options include invasive
hemodynamic monitoring, intravenous inotropic support, and mechanical
circulatory support.
Cardiogenic shock following cardiac surgery has been demonstrated to
carry a very poor prognosis10–13. Likewise,
conventional cardiac surgery in the patient presenting with cardiogenic
shock is often associated with suboptimal operative outcomes. While the
operation may be targeted at reversing the inciting insult, whether it
be coronary ischemia or acute valvular pathology, the early-results have
been dismal14. However, longer-term impacts following
cardiac surgery in the shock state has been less established. This study
aims at investigating the long-term outcomes of conventional cardiac
surgical procedures in cardiogenic shock patients.