Valvular Cardiogenic Shock: Pathophysiology, Advanced Mechanical Circulatory Support, Multidisciplinary Management and Structural Heart Interventions

Valvular cardiogenic shock (VCS) is an underrecognized and highly fatal subset of cardiogenic shock, distinct from ischemic cases. It arises from acute valvular conditions such as mitral regurgitation due to papillary muscle rupture, severe aortic stenosis, or acute aortic regurgitation. The increasing use of temporary mechanical circulatory support (MCS)—including microaxial flow pumps, VA-ECMO, and ECMELLA—has improved short-term stabilization but presents intricate technical and hemodynamic challenges. In patients with severe valve dysfunction, inappropriate device selection can worsen cardiac filling pressures or cause structural damage. Meanwhile, advances in transcatheter procedures such as TEER, BAV, and TAVR have opened new possibilities for rapid, bedside interventions, demanding close coordination between intensivists, interventional cardiologists, and surgeons. Despite these advances, evidence-based protocols for diagnosis, device management, and interdisciplinary workflows remain limited.This Research Topic aims to bridge critical knowledge and practice gaps in the diagnosis and treatment of VCS. It seeks to define standardized hemodynamic monitoring, refine MCS selection and safety parameters, and support early integration of structural interventions into clinical pathways. By fostering collaboration between structural cardiology, cardiac critical care, and surgery, this initiative will promote unified strategies to streamline decision-making, reduce procedural complications, and improve survival in this complex patient population.To gather further insights into the management of valvular cardiogenic shock, we welcome articles addressing, but not limited to, the following themes:o Hemodynamics and pathophysiology of VCS, including invasive modeling and clinical phenotyping.o Optimization of MCS device selection, timing, and venting in severe valvular dysfunction.o Prevention and management of device-induced valvular trauma and structural injury.o Emergency percutaneous structural interventions (TEER, TAVR, BAV, Valve-in-Valve procedures and paravalvular leak closure) for acute stabilization.o Risk stratification using biomarkers, imaging, and prognostic scoring systems.o Development and evaluation of multidisciplinary “Shock Team” frameworks for acute valvular emergencies.o Surgical, transcatheter, and hybrid approaches in unstable patients.Article types: Original Research, Prospective/retrospective trials, Reviews, Mini-Reviews**Topic Editor Elvin Khedi is an advisor for Elucid and proctorship for Abbott. No other Topic Editors declare any conflicts of interest. Topic editors: Andi Rroku, Tharusan Thevathasan, Elvin Kedhi Source: https://www.frontiersin.org/research-topics/83451/valvular-cardiogenic-shock-pathophysiology-advanced-mechanical-circulatory-support-multidisciplinary-management-and-structural-heart-interventions