Background: Recently, mechanical support obtained with the combination of venoarterial extracorporeal membrane oxygenation (VA-ECMO) and an Impella device, together referred to as ECPELLA, has been shown to be effective for acute myocardial infarction with cardiogenic shock. However, methods for withdrawing VA-ECMO in acute myocardial infarction cases complicated by right ventricular dysfunction are yet to be established. Here, we report the effective use of inhaled nitric oxide during the weaning of VA-ECMO from the ECPELLA management of a patient with acute myocardial infarction with cardiogenic shock.
Case Summary: An 81-year-old man with an acute extensive anterior wall myocardial infarction with cardiogenic shock was supported with ECPELLA to improve his haemodynamics. During ECPELLA, the Impella device could not maintain sufficient flow. Echocardiography revealed a small left ventricle and an enlarged right ventricle, indicating acute right heart failure. Inhaled nitric oxide was initiated to reduce right ventricle afterload, which decreased pulmonary artery pressure from 34/20 to 27/13 mmHg, improved right and left ventricle sizes, and stabilized the Impella support. Afterward, VA-ECMO could be withdrawn because the Impella alone was sufficient for haemodynamic support.
Discussion: Inhaled nitric oxide improved right ventricle performance in a patient with severe myocardial infarction with right heart failure supported by ECPELLA. Thus, we suggest that inhaled nitric oxide facilitates the weaning of VA-ECMO from patients with refractory right ventricular dysfunction who are supported by ECPELLA.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10422691 | PMC |
| http://dx.doi.org/10.1093/ehjcr/ytad369 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Exploring the Potential Effect of GLP1R Agonism on Common Ageing-Related Diseases via Glucose Reduction: A Mendelian Randomization Study.
J Gerontol A Biol Sci Med Sci
January 2025
Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China.
Background: Glucagon-like peptide-1 receptor agonists (GLP1RAs) are widely used in manageing type 2 diabetes mellitus and weight control. Their potential in treating ageing-related diseases has been gaining attention in recent years. However, the long-term effects of GLP1RAs on these diseases have yet to be fully revealed.
View Article and Find Full Text PDFDetecting Hemorrhagic Myocardial Infarction With 3.0-T CMR: Insights Into Spatial Manifestation, Time-Dependence, and Optimal Acquisitions.
JACC Cardiovasc Imaging
January 2025
Department of Radiology and Imaging Sciences and Krannert Cardiovascular Research Center, Indiana University School of Medicine, Indianapolis, Indiana, USA. Electronic address:
Background: Hemorrhagic myocardial infarction (hMI) can rapidly diminish the benefits of reperfusion therapy and direct the heart toward chronic heart failure. T2∗ cardiac magnetic resonance (CMR) is the reference standard for detecting hMI. However, the lack of clarity around the earliest time point for detection, time-dependent changes in hemorrhage volume, and the optimal methods for detection can limit the development of strategies to manage hMI.
View Article and Find Full Text PDFIroning It Out: Unraveling the Mysteries of Hemorrhage Post Myocardial Infarction With Cardiac MRI.
JACC Cardiovasc Imaging
January 2025
Department of Cardiovascular Medicine, Stanford University, Stanford, California, USA; Department of Radiology, Stanford University, Stanford, California, USA. Electronic address:
Cardiovascular Outcomes With Antidiabetic Drugs in People With Type 2 Diabetes and a Prior Stroke.
Mayo Clin Proc
January 2025
Department of Internal Medicine, Korea University Anam Hospital, Seoul, Republic of Korea; Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea. Electronic address:
Objective: To assess the comparative effectiveness of sodium-glucose cotransporter 2 inhibitors (SGLT2i), thiazolidinediones (TZD), and dipeptidyl peptidase-4 inhibitors (DPP-4i) for the cardiorenal outcomes and mortality in individuals with type 2 diabetes and a prior stroke.
Patients And Methods: Using the Korean National Health Insurance Service database from 2014 to 2021, a new-user cohort was established through propensity score matching for SGLT2i, TZD, and DPP-4i. The primary outcomes were major adverse cardiovascular events (MACE), comprising myocardial infarction, ischemic stroke, and cardiovascular death.
Transcatheter Left Ventricular Reconstruction in Heart Failure Patients With Prior Anterior Myocardial Infarction: The Prospective ALIVE Trial.
JACC Heart Fail
January 2025
The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Background: Left ventricular (LV) dilatation and extensive scar portend a poor prognosis in heart failure (HF). The Revivent TC system (BioVentrix Inc) is used either during a hybrid transcatheter-surgical or a surgical-only procedure to exclude transmural scar and reduce LV dimensions.
Objectives: The purpose of this study was to examine the safety and efficacy of the Revivent TC® anchor system in patients with HF.
Want 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!