ECMO support for the treatment of cardiogenic shock due to left ventricular free wall rupture

Formica, Francesco; Corti, Fabrizio; Avalli, Leonello; Paolini, Giovanni

doi:10.1510/icvts.2004.096883

Cited by 10 publications

(14 citation statements)

References 9 publications

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“…Currently, there are three possible emergency treatments for CPA due to LVFWR, and the first is pericardiocentesis and drainage. [1][2][3][4] However, this procedure may be difficult to perform while continuing effective chest compressions. The second method involves pericardial drainage, primary hemostasis, and direct cardiac massage with left intercostal thoracotomy.…”

Section: Discussionmentioning

confidence: 99%

“…The third approach is to use ECMO. 2,3 We were able to establish ECMO as early as 10 minutes after CPA, as skilled doctors and clinical engineers were available continuously at our university hospital. As in the present case, when CPA occurs before a definitive diagnosis, AAD may be a cause of pericardial effusion, 6 and lifesaving is expected to be difficult with left thoracotomy.…”

Section: Discussionmentioning

confidence: 99%

“…However, in cases of cardiac arrest, it is difficult to perform pericardiocentesis during chest compressions, and emergency left thoracotomy or initiating ECMO may be considered. [2][3][4] We encountered a case of cardiopulmonary arrest (CPA) due to LVFWR that was treated with VA ECMO and immediate induction of targeted temperature management (TTM).…”

Section: Introductionmentioning

confidence: 99%

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A case of cardiopulmonary arrest due to left ventricular free wall rupture successfully treated with sutureless repair supported by venoarterial extracorporeal membrane oxygenation

Suzuki

Ichibayashi

Yamamoto

et al. 2021

Clinical Case Reports

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A case of cardiopulmonary arrest due to left ventricular free wall rupture successfully treated with sutureless repair supported by venoarterial extracorporeal membrane oxygenation

Suzuki

Ichibayashi

Yamamoto

et al. 2021

Clinical Case Reports

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“…10 Acute nonsurgical treatment of LVFWR consists of aggressive volume resuscitation with inotropic and vasopressor support, pericardiocentesis, and percutaneous circulatory support, such as intra-aortic balloon counterpulsation and extracorporeal membrane oxygenation. 11,12 Surgical repair involving infarctectomy and patching is the only definitive treatment, yet even successful surgery carries a high mortality rate. 13 Echocardiography is crucial in the prompt diagnosis of LVFWR and is often the only readily accessible diagnostic method in the presence of an acutely deteriorating patient.…”

Section: Discussionmentioning

confidence: 99%

Prompt Recognition of Left Ventricular Free-Wall Rupture Aided by the Use of Contrast Echocardiography

Okabe¹,

Julien²,

Kaliyadan³

et al. 2015

Texas Heart Institute Journal

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L eft ventricular free-wall rupture (LVFWR) is a life-threatening sequela of acute myocardial infarction. Contrast-enhanced echocardiography can be used urgently at the bedside to identify LVFWR. Early recognition is paramount, because emergency surgical correction is the only treatment. We describe the use of contrast-enhanced echocardiography in a patient who sustained pulseless electrical activity 5 days after a myocardial infarction (MI). Direct views of a tear in the myocardium enabled rapid confirmation of the diagnosis and expeditious surgical treatment. Case ReportIn January 2013, a 59-year-old woman with hypertension and hypercholesterolemia presented at another hospital with a 2-day history of chest pain. She was treated for non-ST-segment-elevation MI. Her initial serum troponin T level was 0.96 ng/mL (normal, <0.01 ng/mL). An electrocardiogram revealed ST-segment elevation in lead aVL, borderline but nondiagnostic ST-segment elevation in adjacent lead I, rsR′ in lead V 2 , and ST-segment depression in the anterolateral and inferior leads (Fig. 1). The patient was admitted to the intensive care unit and was given aspirin, low-molecularweight heparin, a glycoprotein IIb/IIIa inhibitor, and a nitroglycerin infusion. Her serum troponin T level peaked at 3.79 ng/mL.The patient was transferred to our hospital the next day for elective cardiac catheterization. An electrocardiogram revealed a recent posterolateral infarction (Fig. 2). Coronary angiograms showed an occluded left circumflex coronary artery; faint collateral vessels from a patent, dominant right coronary artery; a 70% stenosis of the first diagonal branch; and a 90% stenosis of the right posterior descending artery (RPDA). Left ventriculograms revealed severe hypokinesis of the inferolateral wall and overall mild left ventricular (LV) dysfunction. No intervention was performed, because the patient was no longer symptomatic and was well beyond 24 hours from symptom onset and presentation.On hospital day 3, the patient sustained a retroperitoneal hemorrhage and was transfused with 2 units of packed red blood cells. On hospital day 5, she became acutely unresponsive and pulseless while conversing with her family. Advanced cardiac life support was initiated immediately. She remained hemodynamically unstable and needed intravenous fluids and vasopressors. A bedside transthoracic echocardio-

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“…This approach may reduce the risk of re-rupture during the early postoperative period. In the last 20 years, ECMO has emerged as a rescue tool to warrant a rapid haemodynamic stability in such patients presented with acute cardiogenic shock or even cardiac arrest [19,20] . ECMO may be use also to stabilize patients affected by LVFWR in referring hospitals [21,22] .…”

Section: Left Ventricular Free Wall Rupturementioning

confidence: 99%

Acute mechanical complications in patients suffering from acute myocardial infarction

Formica¹,

Mariani²,

D’Alessandro³

2019

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Acute mechanical complications following acute myocardial infarction have an incidence less the 1% in the era post coronary and systemic thrombolysis. However, the early mortality is still high even after surgical therapy, reaching 70%. Left ventricle free wall rupture, ventricular septal defect and papillary muscle rupture represent the most challenging complications after myocardial infarction. Prompt diagnosis, appropriate medical therapy and mechanical support, such as intra-aortic balloon pump and extracorporeal membrane oxygenation, and urgent or emergency surgical operation may favor to obtain encouraging results and acceptable long-term outcome.

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ECMO support for the treatment of cardiogenic shock due to left ventricular free wall rupture

Cited by 10 publications

References 9 publications

A case of cardiopulmonary arrest due to left ventricular free wall rupture successfully treated with sutureless repair supported by venoarterial extracorporeal membrane oxygenation

A case of cardiopulmonary arrest due to left ventricular free wall rupture successfully treated with sutureless repair supported by venoarterial extracorporeal membrane oxygenation

Prompt Recognition of Left Ventricular Free-Wall Rupture Aided by the Use of Contrast Echocardiography

Acute mechanical complications in patients suffering from acute myocardial infarction

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