1. Staged revascularization and multi-modal mechanical circulatory supports in a patient with severe cardiogenic shock due to acute-on-chronic coronary syndrome.
- Author
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Horimoto, Miri, Tsutsui, Masahiro, Mochizuki, Nobuhiro, Setogawa, Yuki, Suzuki, Fumitaka, Narita, Masahiko, Hirofuzi, Aina, Kunioka, Shingo, Shirasaka, Tomonori, Ishikawa, Natsuya, and Kamiya, Hiroyuki
- Subjects
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CARDIOGENIC shock , *ARTIFICIAL blood circulation , *CORONARY artery bypass , *ST elevation myocardial infarction , *ACUTE coronary syndrome , *PERCUTANEOUS coronary intervention - Abstract
Acute coronary syndrome with cardiogenic shock is a life-threatening condition, but with planned staged treatment combined with coronary revascularization and mechanical circulatory supports its management is increasingly possible. Here, we present our successful life-saving case. A 76-year-old male patient was diagnosed with ST-elevation myocardial infarction with cardiogenic shock due to severe stenosis of the left main coronary artery based on the severe triple vessel disease. We initially introduced Impella CP and performed a percutaneous coronary intervention without stenting on the patient. We maintained hemodynamics with Impella CP and performed coronary artery bypass grafting after a week. Intraoperatively, Impella CP was left to function as a left ventricular vent. The patient required upgrading to Impella 5.5 plus veno-arterial extracorporeal membrane oxygenation postoperatively, but his condition gradually improved, all mechanical circulatory supports could be weaned off, and he eventually survived. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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