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With an incidence of 2\u201320%, PCCS is associated with high morbidity, mortality, and healthcare resource utilization. This review explores the pathophysiology of PCCS while emphasizing mechanisms such as direct myocardial damage, ischaemia-reperfusion injury, and systemic effects of extracorporeal circulation. It also discusses key diagnostic tools for PCCS including echocardiography, pulmonary artery catheters, vasoactive inotropic scores (VIS), and lactate clearance, which facilitate early recognition and management. Treatment pathways centred on temporary mechanical circulatory support (tMCS), tailored to clinical scenarios such as the inability to wean from CPB or refractory LCOS. The pivotal role of the multi-disciplinary Heart Team in decision-making, collaboration, and patient-centred care is highlighted. Finally, weaning protocols and considerations for long-term outcomes are discussed, underscoring the need for timely interventions and a personalized approach. Advances in PCCS management continue to evolve, aiming to improve survival and long-term outcomes for this high-risk population.<\/jats:p>","DOI":"10.1093\/eurheartjsupp\/suaf005","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T17:34:09Z","timestamp":1738690449000},"page":"iv12-iv22","source":"Crossref","is-referenced-by-count":4,"title":["Current insights on temporary mechanical circulatory support in adults with post-cardiotomy cardiogenic shock"],"prefix":"10.1093","volume":"27","author":[{"given":"Ahmad","family":"Mahajna","sequence":"first","affiliation":[{"name":"Cardio-Thoracic Surgery Department, Maastricht University Medical Centre , P. Debyelaan 25, Maastricht 6202 AZ ,","place":["The Netherlands"]},{"name":"Cardiac Surgery Department, Rambam Medical Center Campus , PO Box 9602, Haifa 3109601 ,","place":["Israel"]},{"name":"Cardiovascular Research Institute Maastricht (CARIM), 6229 ER Maastricht, The","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sascha","family":"Ott","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anaesthesiology and Intensive Care Medicine, Deutsches Herzzentrum der Charit\u00e9 , Augustenburger Pl. 1, 13353 Berlin ,","place":["Germany"]},{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Augustenburger Pl. 1 , 13353 Berlin ,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Potsdamer Strasse 58, 10785 Berlin ,","place":["Germany"]},{"name":"Outcomes Research Consortium, Department of Anesthesiology, Cleveland Clinic, Cleveland, OH, 44195","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assad","family":"Haneya","sequence":"additional","affiliation":[{"name":"Heart Centre Trier, Department of Cardiothoracic Surgery, Barmherzige Brueder Hospital , Nordallee 1, Trier 54292 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Leick","sequence":"additional","affiliation":[{"name":"Heart Centre Trier, Department of Internal Medicine III\/Cardiology, Barmherzigen Brueder Hospital , Nordallee 1, Trier 54292 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Pilarczyk","sequence":"additional","affiliation":[{"name":"Intensive Care and Emergency Medicine, Klinikum Hochsauerland GmbH , Stolte Ley 5, Arnsberg 59759 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1638-0493","authenticated-orcid":false,"given":"Sharaf-Eldin","family":"Shehada","sequence":"additional","affiliation":[{"name":"Department for Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center, University Hospital Essen , Hufelandstra\u00dfe 55, Essen 45147 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gil","family":"Bolotin","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Rambam Medical Center Campus , PO Box 9602, Haifa 3109601 ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1777-2045","authenticated-orcid":false,"given":"Roberto","family":"Lorusso","sequence":"additional","affiliation":[{"name":"Cardio-Thoracic Surgery Department, Maastricht University Medical Centre , P. 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