Background: Acute severe mitral regurgitation (MR) associated with cardiogenic shock is a life-threatening emergency. Traditional teaching has focused on the need for emergent coronary angiography and/or intra-aortic balloon counterpulsation in preparation for emergent open-heart surgery for repair/replacement. Unfortunately, emergent open-heart surgery in patients with acute MR complicated by cardiogenic shock is associated with 25-46% perioperative mortality. New devices have provided additional options for stabilization prior to emergent surgery which facilitate improved outcomes.
Case Summary: We present two cases of acute severe MR resulting in cardiogenic shock and profound hypoxaemia. TandemHeart mechanical circulatory support with an oxygenator spliced into the circuit, akin to veno-arterial extracorporeal membrane oxygenation (ECMO), facilitated haemodynamic stabilization and decongestion of the lungs facilitating successful bridge to mitral valve surgery. Successful discharge to home was achieved in both patients with good neurological outcomes and sustained long-term functional recovery at 18 and 14 months, respectively.
Discussion: Selective use of the TandemHeart, with or without ECMO, facilitates management of the critically ill cardiogenic shock patient with acute severe MR.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7047057 | PMC |
| http://dx.doi.org/10.1093/ehjcr/ytz234 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Cardiogenic shock in women: From risk factors to therapy.
Kardiol Pol
December 2024
Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
Cardiogenic shock (CS) in women is a serious cardiovascular (CV) event associated with a high mortality rate. Non-ischemic etiologies are the most common etiologies in women, such as stress-induced cardiomyopathy, peripartum/postpartum cardiomyopathy, heart failure-related CS, or CS due to myocarditis or valvular heart disease. Although not being the most common etiology in women, acute myocardial infarction is still an important one.
View Article and Find Full Text PDFA Case Study of Aberrant Aortic Origin of the Right Coronary Artery.
Discoveries (Craiova)
March 2024
Interventional Cardiologist, Apollo Hospitals Chennai Greams Road, India.
This case report examines a rare cardiovascular abnormality, the Aberrant Aortic Origin of the Right Coronary Artery (AAORCA), in a 75-year-old patient with a history of myocardial infarction, acute renal injury, and cardiogenic shock. Rapid medical intervention, including coronary angioplasty, demonstrated the significance of prompt care. Chronic issues, including tobacco use and left ventricular dysfunction, complicated matters, emphasizing the importance of comprehensive long- term therapy.
View Article and Find Full Text PDFPitfalls of computed tomography angiography examination in veno-arterial extracorporeal membrane oxygenation patients: a case report of a patient with cardiac rupture.
J Cardiothorac Surg
December 2024
Department of Critical Care, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, 317000, China.
Background: Veno-arterial (V-A) extracorporeal membrane oxygenation (ECMO) is commonly used for patients with cardiac arrest, cardiogenic shock, or heart failure and is a life-saving technique. Computed tomography angiography (CTA) examination in patients on ECMO presents certain challenges. Due to the dual circulation characteristics of blood flow in ECMO patients, vascular imaging and interpretation can be difficult and may even present pitfalls.
View Article and Find Full Text PDFSuccessful treatment of cardiac dysfunction due to left main trunk obstruction and severe acute aortic regurgitation secondary to acute type A aortic dissection using Impella: a case report.
J Cardiothorac Surg
December 2024
Department of Cardiovascular Surgery, Kanazawa University, Takaramachi 13-1, Kanazawa, 920-8641, Japan.
Background: Acute type A aortic dissection (A-AAD) with severe acute aortic regurgitation (AR) and coronary involvement is a potentially fatal condition that causes left ventricular volume overload and catastrophic acute myocardial infarction. We present the successful management of a patient using Impella 5.5 following cardiopulmonary arrest caused by A-AAD with severe acute AR and left main trunk (LMT) obstruction.
View Article and Find Full Text PDFAcute Decompensated Valvular Disease in the Intensive Care Unit.
JACC Adv
December 2024
TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Acute decompensated valvular disease encompasses a group of complex and challenging conditions, which are often the primary reason for admission to the cardiac intensive care unit and can also complicate the management of other primary cardiac disorders. Critically ill patients with valvular disease also present unique diagnostic and management challenges. Historically, medical and percutaneous interventional therapies have been limited and surgery was the only definitive treatment; however, surgical risk can at times be prohibitive.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!