Extracorporeal Membrane Oxygenation as a Method of Mechanical Support of Blood Circulation in Endovascular Myocardial Revascularization with Underlying Cardiogenic Shock: a Case Report

  • B. M. Todurov Heart Institute of the Ministry of Health of Ukraine, Kyiv, Ukraine; Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine
  • O. A. Loskutov Heart Institute of the Ministry of Health of Ukraine, Kyiv, Ukraine; Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine
  • O. M. Druzhina Heart Institute of the Ministry of Health of Ukraine, Kyiv, Ukraine; Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine
  • H. I. Kovtun Heart Institute of the Ministry of Health of Ukraine, Kyiv, Ukraine
  • S. R. Maruniak Heart Institute of the Ministry of Health of Ukraine, Kyiv, Ukraine
DOI: https://doi.org/10.30702/ranspaorg/02_21.3103/0134-41/36-02
Keywords: extracorporeal life support, coronary heart disease, myocardial infarction, cardiogenic shock

Abstract

Today, the use of mechanical circulatory support to maintain proper hemodynamics in percutaneous coronary interventions in high-risk patients opens up new avenues for treating such challenging patients. Moreover, it has enabled to treat cases that were once considered overwhelming. The safety and efficacy of using the extracorporeal membrane oxygenation (ECMO) technique is currently being widely studied, however, the literature describes only isolated cases of using this technique when performing percutaneous angioplasty in patients with acute myocardial infarction complicated by cardiogenic shock. In this clinical case, an example of ECMO connection for endovascular myocardial revascularization during percutaneous coronary intervention (PCI) in a patient with myocardial infarction complicated by cardiogenic shock is described.

References

  1. Babaev A, Frederick PD, Pasta DJ, Every N, Sichrovsky T, Hochman JS; NRMI Investigators. Trends in management and outcomes of patients with acute myocardial infarction complicated by cardiogenic shock. JAMA. 2005 Jul 27;294(4):448-54. https://doi.org/10.1001/jama.294.4.448.
  2. Obradovic D, Freund A, Desch S, Thiele H. Infarktbedingter kardiogener Schock [Cardiogenic Shock Complicating Myocardial Infarction]. 2020 May;145(9):624-632. German. https://doi.org/10.1055a-106-3325.
  3. Reynolds HR, Hochman JS. Cardiogenic shock: current concepts and improving outcomes. 2008 Feb 5;117(5):686-97. https://doi.org/10.1161/CIRCULATIONAHA.106.613596
  4. Freund A, Desch S, Thiele H. Revascularization in cardiogenic shock. Herz. 2020 Sep;45(6):537-541. https://doi.org/10.1007/s00059-020-04956-6.
  5. Pyka L, Pres D, Przybylski R, Pacholewicz J, Poloński L, Zembala M, et al. Mechanical circulatory support in cardiogenic shock – what every interventional cardiologist should know. Postepy Kardiol. Interwencyjnej. 2014;10(3):195-200. https://doi.org/10.5114/pwki.2014.45147
  6. Chakaramakkil MJ, Sivathasan C. ECMO and Short-term Support for Cardiogenic Shock in Heart Failure. Curr Cardiol Rep. 2018 Aug 16;20(10):87. https://doi.org/10.1007/s11886-018-1041-4
  7. Nichol G, Karmy-Jones R, Salerno C, Cantore L, Becker L. Systematic review of percutaneous cardiopulmonary bypass for cardiac arrest or cardiogenic shock states. Resuscitation. 2006 Sep;70(3):381-94. https://doi.org/10.1016/j.resuscitation.2006.01.018
  8. Aubron C, DePuydt J, Belon F, Bailey M, Schmidt M, Sheldrake J, et al. Predictive factors of bleeding events in adults undergoing extracorporeal membrane oxygenation. Ann Intensive Care. 2016 Dec;6(1):97. https://doi.org/10.1186/s13613-016-0196-7
  9. Mateen FJ, Muralidharan R, Shinohara RT, Parisi JE, Schears GJ, Wijdicks EF. Neurological injury in adults treated with extracorporeal membrane oxygenation. Arch Neurol. 2011 Dec;68(12):1543-9. https://doi.org/10.1001/archneurol.2011.209
  10. Puricel S, Adorjan P, Oberhänsli M, Stauffer JC, Moschovitis A, Vogel R, et al. Clinical outcomes after PCI for acute coronary syndrome in unprotected left main coronary artery disease: insights from the Swiss Acute Left Main Coronary Vessel Percutaneous Management (SALVage) study. EuroIntervention. 2011 Oct 30;7(6):697-704. https://doi.org/10.4244/EIJV7I6A112
  11. Dardas P, Mezilis N, Ninios V, Theofilogiannakos EK, Tsikaderis D, Tsotsolis N, et al. ECMO as a bridge to high-risk rotablation of heavily calcified coronary arteries. Herz. 2012 Mar;37(2):225-30. https://doi.org/10.1007/s00059-011-3489-5
  12. Rihal CS, Naidu SS, Givertz MM, Szeto WY, Burke JA, Kapur NK, et al. 2015 SCAI/ACC/HFSA/STS Clinical expert consensus statement on the use of percutaneous mechanical circulatory support devices in cardiovascular care. J Am Coll Cardiol. 2015 May 19;65(19):e7-e26. https://doi.org/10.1016/j.jacc.2015.03.036
  13. Westaby S, Anastasiadis K, Wieselthaler GM. Cardiogenic shock in ACS. Part 2: role of mechanical circulatory support. Nat Rev Cardiol. 2012 Jan 10;9(4):195-208. https://doi.org/10.1038/nrcardio.2011.205
  14. Bakhtiary F, Keller H, Dogan S, Dzemali O, Oezaslan F, Meininger D, et al. Venoarterial extracorporeal membrane oxygenation for treatment of cardiogenic shock: clinical experiences in 45 adult patients. J Thorac Cardiovasc Surg. 2008 Feb;135(2):382-8. https://doi.org/10.1016/j.jtcvs.2007.08.007
Published
2021-03-31
How to Cite
Todurov, B. M., Loskutov, O. A., Druzhina, O. M., Kovtun, H. I., & Maruniak, S. R. (2021). Extracorporeal Membrane Oxygenation as a Method of Mechanical Support of Blood Circulation in Endovascular Myocardial Revascularization with Underlying Cardiogenic Shock: a Case Report. Transplantation and Artificial Organs, (1(02), 34-41. https://doi.org/10.30702/ranspaorg/02_21.3103/0134-41/36-02
Issue
Transplantation and artificial organs №1(02) 2021
Section
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