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Carbon monoxide poisoning is one of the leading causes of mortality and morbidity by poisoning in the world. Signs and symptoms are nonspecific and related to impaired oxygen delivery to tissues, with the brain being the most affected organ due to its high oxygen demand. CO-Hb is a poor indicator of severity and long-term outcome, with clinicians relying more on clinical features such as level of consciousness and need for intubation, organ dysfunction and shock and also pH level. A 45-year-old female was found unconscious in her home with the fireplace lit and smoke all over the house. She was last seen well 18 hours before. She was brought to the emergency department and was admitted to the ICU in coma and cardiogenic shock, with a metabolic acidosis with hyperlactacidemia and a CO-Hb level of 15.5%. Laboratorial investigation revealed hepatic cytolysis, acute renal failure, rhabdomyolysis and a troponin I level of 338 ng/L. ECG showed no acute myocardial ischemia. Echocardiogram revealed diffuse hypokinesia with an ejection fraction of 25%. Head CT scan showed bilateral and symmetrical hypodensities of the globus pallidus. The patient underwent hyperbaric oxygen treatment with full neurological and cardiac recovery, allowing extubation 48 hours after admission. This rare severe case of coma due to carbon monoxide intoxication with globus pallidus injury and cardiogenic shock was successfully treated with hyperbaric oxygen, showing that it can be the right treatment choice in these cases, with an excellent impact on neurological and cardiac outcome. [ABSTRACT FROM AUTHOR]

Thrombosis of mechanical valve prostheses is a rare but dramatic complication of valve replacement, as it is often fatal. Inadequate anticoagulant therapy is often to blame. Clinical presentation is variable, and rapid hemodynamic deterioration is often present. We report a case of mechanical valve thrombosis in the mitral position, in a 40-year-old patient admitted to the emergency department with cardiogenic shock. Thrombolysis was successfully performed. The evolution was marked by a clear hemodynamic improvement, with a follow-up echocardiogram showing normalization of the transmitral gradient. [ABSTRACT FROM AUTHOR]

Acute Coronary Syndrome (ACS) are one of the main causes of mortality in France. Patients presenting with ACS are typically hospitalized in a specialized cardiology ward. The main objective of this study was to describe, characterize and evaluate the outcome of patients hospitalized for ACS in a generalist intensive care unit (rather than a cardiac care unit). This was a retrospective study. Our population consisted of ACS patients admitted to an intensive care unit in a hospital center (Centre Hospitalier de Troyes) between 2012 and 2021. All patients admitted for ACS to the intensive care unit and who underwent coronary angiography were included. In 10 years, 104 patients, or 3.8% of ACS patients who underwent coronary angiography were admitted to intensive care. The majority were admitted after recovered cardiac arrest (72%) and were in cardiogenic shock (68%), accounting for a high in-hospital mortality (45.2%). In-hospital mortality was 45.2%. In multivariate analysis, the GRACE score was associated with in-hospital mortality (OR for each additional point = 1.024, 95% confidence interval 1.006–1.045, p = 0.01). Among the survivors, 88% had good neurological function when leaving the hospital. Mortality of ACS patients in intensive care was close to 50%. However, the neurological prognosis of the surviving patients was good. This population is rarely mentioned in the literature, and deserves to be evaluated by multicenter, prospective registries, with a view to improving management and prognosis. [ABSTRACT FROM AUTHOR]

Introduction: Acute Coronary Syndrome (ACS) are one of the main causes of mortality in France. Patients presenting with ACS are typically hospitalized in a specialized cardiology ward. The main objective of this study was to describe, characterize and evaluate the outcome of patients hospitalized for ACS in a generalist intensive care unit (rather than a cardiac care unit)., Methods: This was a retrospective study. Our population consisted of ACS patients admitted to an intensive care unit in a hospital center (Centre Hospitalier de Troyes) between 2012 and 2021. All patients admitted for ACS to the intensive care unit and who underwent coronary angiography were included., Results: In 10 years, 104 patients, or 3.8% of ACS patients who underwent coronary angiography were admitted to intensive care. The majority were admitted after recovered cardiac arrest (72%) and were in cardiogenic shock (68%), accounting for a high in-hospital mortality (45.2%). In-hospital mortality was 45.2%. In multivariate analysis, the GRACE score was associated with in-hospital mortality (OR for each additional point = 1.024, 95% confidence interval 1.006-1.045, p = 0.01). Among the survivors, 88% had good neurological function when leaving the hospital., Discussion: Mortality of ACS patients in intensive care was close to 50%. However, the neurological prognosis of the surviving patients was good. This population is rarely mentioned in the literature, and deserves to be evaluated by multicenter, prospective registries, with a view to improving management and prognosis., Competing Interests: Déclaration de liens d'intérêts Les auteurs déclarent n'avoir aucun lien d'intérêt en relation avec cet article., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

L'œdème pulmonaire hydrostatique constitue une complication reconnue de l'ECMO périphérique (« Extracorporal Membrane Oxygenation ») liée à l'augmentation de la post-charge du ventricule gauche par le flux rétrograde dans l'aorte descendante. Plusieurs techniques ont été décrites afin de décharger le ventricule gauche : ballon de contre-pulsion intra-aortique, Impella® (Abiomed, Danvers, MA), centralisation de l'ECMO ou encore l'atrioseptotomie percutanée au ballon (manœuvre de Rashkind). Nous décrivons deux cas de choc cardiogénique ayant nécessité la mise en place d'une ECMO veino-artérielle compliqués d'œdème pulmonaire hydrostatique pour laquelle l'indication d'une manœuvre de Rashkind a été retenue. Le premier cas est celui d'un infarctus antérieur vu tardivement compliqué d'un arrêt cardiorespiratoire et d'un choc cardiogénique. L'apparition d'une hypoxie réfractaire et d'images radiographiques alvéolo-interstitielles bilatérales ont motivé la réalisation d'une atrioseptotomie de décharge par voie percutanée. Le second cas est celui d'une thrombose de stent compliquée d'un choc cardiogénique et d'un arrêt cardiorespiratoire. L'échographie transoesophagienne procédurale de l'atrioseptotomie réalisée retrouve un volumineux thrombus de l'oreillette gauche ainsi qu'une thrombose des veines pulmonaires contre-indiquant la réalisation de la manœuvre de Rashkind. Ces deux cas illustrent l'importance et la gravité de l'œdème pulmonaire hydrostatique sous ECMO. Le premier montre la faisabilité de cette technique pour la décharge du ventricule gauche. Le second souligne l'intérêt de l'échographie transoesophagienne à la recherche d'une thrombose des veines pulmonaires participant à l'augmentation de la pression hydrostatique et contre-indiquant la manœuvre de Rashkind. Hydrostatic pulmonary edema is a well-known complication of veinoarterial extracorporeal membrane oxygenation (VA-ECMO) caused by increased left ventricle afterload due to reverse blood flow in the aorta. Several techniques are commonly used for left ventricle venting such as intra-aortic balloon pump, Impella® (Abiomed, Danvers, MA), central surgical cannulation or Rahskind atrial septostomy. We reported two cases of hydrostatic pulmonary edema in patients under VA-ECMO for whom it was decided to perform Rashkind technique. The first is a late anterior myocardial infarction complicated with cardiac arrest and cardiogenic shock. Refractory hypoxemia due to hydrostatic pulmonary edema conducted us to perform atrial septostomy. The second case is a refractory cardiogenic shock due to left main stent thrombosis myocardial infarction. Procedural transesophageal echocardiography revealed a large left atrial thrombus extended to pulmonary veins preventing the procedure. These two cases illustrate the importance and gravity of pulmonary edema induced by VA-ECMO. The first shows that this technique is feasible, allows great left ventricle unloading and improves hypoxemia. The second underlines the interest of performing transesophageal echocardiography to look for pulmonary veins thrombosis that can take part in the elevation of hydrostatic pressure and forbid Rashkind manoeuver. [ABSTRACT FROM AUTHOR]

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À travers le monde, observée surtout en période estivale, l'envenimation scorpionique (ES) constitue un vrai fléau de santé publique. Elle est très répandue dans les régions rurales des pays à climat chaud. En raison de sa fréquence, l'ES est la première (50 à 60 %) de l'ensemble des intoxications déclarées au Centre antipoison au Maroc [1]. Bien que le scorpion jaune soit considéré comme le plus dangereux, parce qu'il exerce une toxicité cardiaque, nous rapportons un cas de toxicité cardiopulmonaire chez un adulte suite à une envenimation par le scorpion noir. Dans moins de 3 % de l'ensemble des piqûres de scorpion, il existe une défaillance d'organes, principalement des perturbations cardiorespiratoires mettant en jeu le pronostic vital. Ces manifestations correspondent à une insuffisance cardiaque aiguë se déclinant sous la forme d'un état de choc et/ou d'un œdème pulmonaire aigu (OAP) [2]. Nous rapportons ici une présentation inhabituelle d'un cas d'envenimation scorpionique sévère compliquée par un OAP et un choc cardiogénique chez un adulte, dont l'évolution a été favorable. [ABSTRACT FROM AUTHOR]

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Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

À travers le monde, observée surtout en période estivale, l'envenimation scorpionique (ES) constitue un vrai fléau de santé publique. Elle est très répandue dans les régions rurales des pays à climat chaud. En raison de sa fréquence, l'ES est la première (50 à 60 %) de l'ensemble des intoxications déclarées au Centre antipoison au Maroc [1]. Bien que le scorpion jaune soit considéré comme le plus dangereux, parce qu'il exerce une toxicité cardiaque, nous rapportons un cas de toxicité cardiopulmonaire chez un adulte suite à une envenimation par le scorpion noir. Dans moins de 3 % de l'ensemble des piqûres de scorpion, il existe une défaillance d'organes, principalement des perturbations cardiorespiratoires mettant en jeu le pronostic vital. Ces manifestations correspondent à une insuffisance cardiaque aiguë se déclinant sous la forme d'un état de choc et/ou d'un œdème pulmonaire aigu (OAP) [2]. Nous rapportons ici une présentation inhabituelle d'un cas d'envenimation scorpionique sévère compliquée par un OAP et un choc cardiogénique chez un adulte, dont l'évolution a été favorable. [ABSTRACT FROM AUTHOR]

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Cardiogenic shock remains one of the leading causes of death in patients with myocardial infarction. The Intra-aortic balloon pump (IABP) has been widely used as a treatment for acute myocardial infarction (AMI), despite recommendations against its routine use. In this paper, our aim is to analyze and share our own experience with IABP in the setting of AMI. We retrospectively reviewed the files of patients admitted with AMI and cardiogenic shock and for whom IABP was inserted between June 2016 and December 2022. 300 patients with AMI and cardiogenic shock were admitted and benefited from IABP insertion and primary coronary revascularization. The overall mortality rate was 62.3%, the site related complication rate was 0.6%, and the overall complications rate (including site related and major bleeding) was 10.6%. There was a significantly higher mortality in the group of patients where the Left Anterior Descending artery (LAD) was the culprit lesion, in the group of patients who required dialysis, the group who had creatinine levels greater than 200 um/L compared to the group who had creatinine lower than 200 um/L, and in patients older than 70 years. Interestingly, no difference in mortality was observed between men and women, single versus multiple vessel disease, and between STEMI and non-STEMI patients. Mortality of AMI complicated by cardiogenic shock and treated by IABP remains high. However, IABP usage is associated with a low complication rate. Better selection criteria for IABP usage versus other more powerful mechanical circulatory support devices in such patients might improve the outcome for the patient. [ABSTRACT FROM AUTHOR]

La cardiomyopathie du péri-partum (CMP-PP) ou syndrome de Meadows, est une cardiomyopathie dilatée survenue pendant ou au décours d'une grossesse, définie par une insuffisance cardiaque avec une fraction d'éjection systolique du ventricule gauche inférieure à 45%. Il s'agit d'une entité pathologique rare dont le mécanisme physiopathologique en cause reste mal élucidé. Sur le plan clinique il s'agit d'une insuffisance cardiaque inopinée d'installation rapide, d'évolution imprévisible avec risque de choc cardiogénique réfractaire justifiant une prise en charge en réanimation cardiovasculaire. La CMP-PP ne nécessite aucun traitement spécifique par rapport aux autres causes d'insuffisance cardiaque. Nous rapportons le cas d'une primigeste de 29 ans qui a consulté à 32 semaines d'aménorrhée dans un tableau d'insuffisance cardiaque congestive en rapport avec une cardiomyopathie du péri-partum. L'objectif de ce travail est de préciser les caractéristiques de cette cardiopathie, qui malgré son caractère exceptionnel ne doit pas être méconnu par l'obstétricien.

Background and Methods: Cardiogenic shock remains one of the leading causes of death in patients with myocardial infarction. The Intra-aortic balloon pump (IABP) has been widely used as a treatment for acute myocardial infarction (AMI), despite recommendations against its routine use. In this paper, our aim is to analyze and share our own experience with IABP in the setting of AMI. We retrospectively reviewed the files of patients admitted with AMI and cardiogenic shock and for whom IABP was inserted between June 2016 and December 2022., Results: 300 patients with AMI and cardiogenic shock were admitted and benefited from IABP insertion and primary coronary revascularization. The overall mortality rate was 62.3%, the site related complication rate was 0.6%, and the overall complications rate (including site related and major bleeding) was 10.6%. There was a significantly higher mortality in the group of patients where the Left Anterior Descending artery (LAD) was the culprit lesion, in the group of patients who required dialysis, the group who had creatinine levels greater than 200 um/L compared to the group who had creatinine lower than 200 um/L, and in patients older than 70 years. Interestingly, no difference in mortality was observed between men and women, single versus multiple vessel disease, and between STEMI and non-STEMI patients., Conclusion: Mortality of AMI complicated by cardiogenic shock and treated by IABP remains high. However, IABP usage is associated with a low complication rate. Better selection criteria for IABP usage versus other more powerful mechanical circulatory support devices in such patients might improve the outcome for the patient., Competing Interests: Conflicts of Interest The authors report no financial relationships or conflicts of interest regarding the content herein., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

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Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Médecine et Santé Tropicales is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Peripartum cardiomyopathy (PP-CMP) or Meadows' syndrom, is a dilated cardiomyopathy which occurs during or following pregnancy. It is characterized by heart failure with a systolic left ventricle ejection fraction of less than 45%. It is rare and its pathophysiologic mechanism is poorly elucidated. From a clinical point of view, it is characterized by unespected heart failure with rapid onset of symptoms, unpredictable evolution and risk of refractory cardiogenic shock, justifying patient's management in Cardiovascular Unit. PP-CMP requires no specific treatment compared to other causes of heart failure. We here report the case of a 29-year old primip at 32 weeks of amenorrhea presenting with congestive heart failure associated with peripartum cardiomyopathy. The aim of this study was to highlight the features of this heart disease which, despite its rarity, should not be disregarded by obstetricians. [ABSTRACT FROM AUTHOR]

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé Objectif Enquête de pratique concernant la prise en charge du choc cardiogénique, les recommandations étant essentiellement basées sur l’avis d’experts. Méthodes Envoi de 1585 e-mails aux médecins « séniors » en réanimation, en France et en Belgique entre septembre 2014 et mars 2015. L’accord était évalué selon la méthodologie de RAND/UCLA. Résultats Cent cinquante-sept réponses ont été recueillies (10 %). Le monitorage continu du débit cardiaque, le remplissage vasculaire, la ventilation non invasive étaient jugés appropriés. L’utilisation de diurétiques systématiques et de la dopamine semblait inappropriée. Il existait un accord fort pour utiliser la dobutamine comme inotrope en première intention. L’usage de la noradrénaline et de l’adrénaline était jugé approprié. Il existait un accord fort pour utiliser une assistance mécanique, en particulier l’ extracorporeal life support au cours du choc cardiogénique réfractaire. Seuls 25 % des répondeurs ont considéré qu’il existait des critères de choc cardiogénique réfractaire clairement définis. Concernant les objectifs de pression artérielle systolique, diastolique et moyenne, 95 % des réponses étaient dans l’intervalle entre 70 à 100, 30 à 50, et 55 à 65 mmHg, respectivement. La cible de SvO 2 était entre 55 et 75 %, et d’index cardiaque entre 1,5 et 3 L/min/m 2 , chez 95 % des répondeurs. Il existait un accord fort pour maintenir l’hémoglobine entre 7 et 9,9 g/dL. Ces différentes réponses étaient comparées avec les avis d’experts, disponibles en termes de recommandations. Conclusion Il existait des différences modestes entre les réponses à notre enquête de pratique et les recommandations d’experts. Purpose Physician survey on cardiogenic shock management; recommendations for the management of patients with cardiogenic shock are based mostly on experts’ opinion. Methods Overall 1585 emails were sent to “senior” intensive care physicians from France and Belgium from September 2014 to march 2015. Response rate was 10% (157 respondents). Agreement was assessed based on RAND/UCLA methodology. Results Continuous monitoring of cardiac output, vascular filling, noninvasive ventilation were deemed appropriate. The use of systematic diuretics and dopamine seemed inappropriate. There was a strong agreement to use dobutamine as inotropic drug in first intention. The use of noradrenaline and adrenaline was considered appropriate. There was a strong agreement to use mechanical circulatory support, in particular extracorporeal life support, in refractory cardiogenic shock. Only 25% of responders felt that there are criteria of refractory cardiogenic shock. Concerning the objectives of systolic, diastolic and mean blood pressure, 95% of the responses were in the range between 70 to 100, 30 to 50, and 55 to 65 mmHg, respectively. The target of SvO 2 was between 55% and 75%, and cardiac index between 1.5 and 3 L/min/m 2 for 95% of responders. There was a strong agreement to maintain hemoglobin between 7 and 9.9 g/dL. Conclusion Based on our physician survey, we found an agreement in vascular filling and early enteral nutrition. Dobutamine and noradrenaline should be the preferred drugs, but not dopamine. Mechanical circulatory support (preferably with extracorporeal support) should be restricted to refractory cardiogenic shock. Those responses differed slightly from experts’ opinion, available in terms of recommendations. [ABSTRACT FROM AUTHOR]

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Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

La rupture myocardique est une complication rare mais souvent fatale de l'infarctus du myocarde aigu récent. Une patiente âgée de 72 ans, présentant une douleur thoracique typiquement angineuse évoluant depuis 34 jours, en insuffisance cardiaque globale était reçue pour une exploration cardio-vasculaire. L'examen physique retrouvait un souffle holosystolique endapexien d'intensité 3/6, irradiant en rayon de roue. La troponine T était élevée à quatre fois la normale et l'ECG objectivait une lésion sous épicardique en antéroseptoapical et une nécrose dans le même territoire. L'échodoppler cardiaque retrouvait un anévrisme septoapicolatéral avec une solution de continuité dans le segment apical du septum interventriculaire (CIV). Traitée par énoxaparine, antiagrégant plaquettaire, diurétique de l'anse, dérivés morphiniques et oxygène, la patiente présente au deuxième jour de son hospitalisation un collapsus cardio-vasculaire et décède dans un tableau de choc cardiogénique malgré l'administration des amines vasopressives à forte dose. La coronarographie na pu être réalisée. Ce cas illustre la gravité des complications mécaniques de l'infarctus du myocarde. L'absence de chirurgie cardiaque dans notre pays explique en grande partie l'évolution fatale de cette CIV ischémique.

Résumé Une femme de 49 ans est admise pour un infarctus du myocarde antérieur étendu avec choc cardiogénique. Une coronarographie retrouve une occlusion ostiale de l’artère coronaire interventriculaire antérieure. Lors du passage du guide, la patiente présente des fibrillations ventriculaires répétées qui vont nécessiter de multiples chocs électriques externes. La réouverture de l’artère est réalisée sous massage cardiaque externe. Deux endoprothèses coronaires actives sont implantées. À la fin de la procédure, après discussion collégiale, un système d’assistance IMPELLA CP ® est posé. Les suites sont marquées par une récupération rapide de la fonction ventriculaire gauche, un retrait de l’IMPELLA CP ® au cinquième jour et une sortie à deux semaines. Malgré l’absence de preuves issues d’études randomisées, l’assistance cardiaque mécanique temporaire est recommandée dans le choc cardiogénique. Le type de système utilisé dépend du contexte clinique et de l’expérience des centres. L’IMPELLA CP ® est une micro-pompe axiale qui est insérée par voie percutanée. Elle assure un débit continu pouvant aller jusqu’à 3,5 L/min. Dans le choc cardiogénique secondaire à un infarctus du myocarde, elle assure un soutien hémodynamique jusqu’à la récupération de la fonction ventriculaire gauche après angioplastie primaire. A 49-year-old woman was admitted for an anterior ST segment elevation myocardial infarction (STEMI). At hospital arrival, she presented with cardiogenic shock. An immediate coronary angiogram showed an occluded ostial left anterior descending artery. During percutaneous coronary intervention (PCI), ventricular fibrillation occurred requiring multiple electrical counter-shocks. The coronary artery was opened during cardiopulmonary resuscitation and two drug-eluting stents were implanted. At the end of the procedure, an Impella CP ® mechanical cardiac-assist device was inserted. Rapid and marked improvement in the hemodynamic status was noted in the following days. The Impella CP ® was withdrawn after five days and the patient was discharged two weeks later. Despite limited data, mechanical cardiac assistance is recommended in cardiogenic shock. Several devices are currently available; the choice of the system is based on the clinical presentation and the experience of each center. The Impella CP ® is a microaxial pump which is inserted percutaneously and delivers up to 3.5 L/min of continuous flow. In cardiogenic shock due to STEMI, this device allows temporary support while awaiting left ventricular recovery after primary PCI. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé Le remplacement valvulaire aortique percutané est une option thérapeutique chez les patients présentant un rétrécissement aortique serré, symptomatique mais à haut risque chirurgical. Cette procédure nécessite l’évaluation préalable par une « heart team » et présente tout de même certaines contre-indications. Nous rapportons le cas d’un homme âgé de 58 ans porteur d’une bicuspidie aortique avec rétrécissement aortique serré compliqué d’un choc cardiogénique. Malgré les contre-indications et devant l’inefficacité d’une valvuloplastie aortique percutanée au ballon, un remplacement valvulaire aortique percutané a dû être réalisé en urgence. Transcatheter aortic valve implantation is a therapeutic option for high-risk patients with severe aortic valve stenosis and with cardiac symptoms. This procedure requires the preliminary evaluation by a “heart team” and presents some contraindications. We report the case of a 58-year-old man with severe bicuspid aortic valve stenosis and cardiogenic shock. In spite of contraindications and because of the failure of balloon aortic valvuloplasty, transcatheter aortic valve implantation was performed in emergency. [ABSTRACT FROM AUTHOR]

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)