Document Detail


Percutaneous ventricular assist device placement during active cardiopulmonary resuscitation for severe refractory cardiogenic shock after acute myocardial infarction.
MedLine Citation:
PMID:  17622370     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cardiogenic shock after acute myocardial infarction is associated with a high mortality rate despite modern reperfusion methods and intra-aortic balloon pump support. For myocardial infarction patients in cardiogenic shock that is refractory to intra-aortic ballon pump counterpulsation and pressors (severe refractory cardiogenic shock), there are limited means to rapidly provide additional hemodynamic support. We present the case of a 49-year-old man who presented with an anterior wall acute myocardial infarction complicated by cardiogenic shock. After resuscitation and stabilization with intra-aortic balloon pump and pressor support, the patient underwent successful emergent percutaneous transluminal coronary angioplasty and stenting of the left anterior descending coronary artery. Forty-eight hours later, the patient again went into severe refractory cardiogenic shock; pulseless electrical activity arrest followed. Cardiopulmonary resuscitation was started, and the patient underwent urgent placement of a TandemHeart percutaneous ventricular assist device. The device enabled the reversal of terminal hemodynamic collapse during active cardiopulmonary resuscitation, subsequent stabilization of the patient, and discharge of the patient from the hospital after device removal. In this patient, the percutaneous ventricular assist device was successful in the treatment of severe refractory cardiogenic shock after acute myocardial infarction.
Authors:
Gary M Idelchik; Pranav Loyalka; Biswajit Kar
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital     Volume:  34     ISSN:  0730-2347     ISO Abbreviation:  Tex Heart Inst J     Publication Date:  2007  
Date Detail:
Created Date:  2007-07-11     Completed Date:  2007-08-01     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  8214622     Medline TA:  Tex Heart Inst J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  204-8     Citation Subset:  IM    
Affiliation:
Division of Cardiology, St. Luke's Episcopal Hospital and The Texas Heart Institute, Houston, Texas 77030, USA.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary / instrumentation
Cardiopulmonary Resuscitation*
Device Removal
Heart-Assist Devices*
Humans
Male
Middle Aged
Myocardial Infarction / complications*,  physiopathology
Severity of Illness Index
Shock, Cardiogenic / etiology,  physiopathology,  therapy*
Stents
Treatment Outcome
Comments/Corrections

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