Using an Impella device to reverse refractory cardiac arrest and enable efficient coronary revascularisation
| Autor: | Laurent Bonello, Nicolas Persico, Christophe Guervilly, Baptiste Verhamme |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty medicine.medical_treatment Electric Countershock 030105 genetics & heredity Return of spontaneous circulation Advanced Cardiac Life Support Coronary Angiography 03 medical and health sciences 0302 clinical medicine Internal medicine medicine.artery Ascending aorta Extracorporeal membrane oxygenation medicine Humans Myocardial infarction Impella Novel Treatment (New Drug/Intervention Established Drug/Procedure in New Situation) Ejection fraction business.industry General Medicine Middle Aged medicine.disease Heart Arrest Right coronary artery Ventricular assist device Cardiology Stents Heart-Assist Devices business 030217 neurology & neurosurgery |
| Zdroj: | BMJ Case Rep |
| ISSN: | 1757-790X |
| Popis: | We report the case of a 54-year-old man who suffered from refractory cardiac arrest secondary to acute myocardial infarction. As veno-arterial extracorporeal membrane oxygenation was unavailable, mechanical chest compression was performed and an Impella device was used that immediately delivered at 3.2 l/min flow to reach the optimal mean arterial pressure. Within 1 min, return of spontaneous circulation was achieved and a 40% left ventricular ejection fraction was measured on echography. Then, the right coronary artery could be revascularised. Despite 62 min low flow, the patient was discharged home on day 19 without neurological sequelae. During refractory cardiac arrest, the European Resuscitation Guidelines indicate that veno-arterial extracorporeal membrane oxygenation should be considered as rescue therapy. Other mechanical circulatory supports such as an Impella device (left ventricular assist device propelling blood in the ascending aorta) can be a promising treatment in select patients; however, insufficient data in humans are available. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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