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Left atrial veno-arterial extracorporeal membrane oxygenation in post-myocardial infarction ventricular septal defect with cardiogenic shock: a case report
BACKGROUND: Ventricular septal defect (VSD) complicating acute myocardial infarction (MI) represents a life-threatening condition and has a mortality of >90% if left untreated. CASE SUMMARY: A 53-year-old man with a prior medical history of diabetes and hypertension presented with cardiogenic sho...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Oxford University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10456208/ https://www.ncbi.nlm.nih.gov/pubmed/37637096 http://dx.doi.org/10.1093/ehjcr/ytad393 |
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author | Jiménez-Rodríguez, Gian Manuel Rojas-Velasco, Gustavo Arias-Sánchez, Eduardo A Manzur-Sandoval, Daniel Vega-Servin, Norman Said Quirazco-Cordova, Ricardo-Eduardo Eid-Lidt, Guering |
author_facet | Jiménez-Rodríguez, Gian Manuel Rojas-Velasco, Gustavo Arias-Sánchez, Eduardo A Manzur-Sandoval, Daniel Vega-Servin, Norman Said Quirazco-Cordova, Ricardo-Eduardo Eid-Lidt, Guering |
author_sort | Jiménez-Rodríguez, Gian Manuel |
collection | PubMed |
description | BACKGROUND: Ventricular septal defect (VSD) complicating acute myocardial infarction (MI) represents a life-threatening condition and has a mortality of >90% if left untreated. CASE SUMMARY: A 53-year-old man with a prior medical history of diabetes and hypertension presented with cardiogenic shock secondary to VSD as a mechanical complication of non-reperfused inferior MI. DISCUSSION: The choice of mechanical support can be difficult in this type of patient. Given the risk of an increased shunt because of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and the increase in left ventricle (LV) afterload, several measures were taken to plan the best ECMO configuration. Given the absence of any real improvement in the LV and an elevated residual ratio between pulmonary and systemic flow (Qp/Qs), the final decision was to switch to left atrial VA-ECMO (LAVA-ECMO). The use of LAVA-ECMO improved the patient’s haemodynamics and allowed his condition to stabilize; LAVA-ECMO is feasible and may be effective as a mechanical circulatory support (MCS) strategy for patients in cardiogenic shock due to VSD as a mechanical complication of acute MI. |
format | Online Article Text |
id | pubmed-10456208 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-104562082023-08-26 Left atrial veno-arterial extracorporeal membrane oxygenation in post-myocardial infarction ventricular septal defect with cardiogenic shock: a case report Jiménez-Rodríguez, Gian Manuel Rojas-Velasco, Gustavo Arias-Sánchez, Eduardo A Manzur-Sandoval, Daniel Vega-Servin, Norman Said Quirazco-Cordova, Ricardo-Eduardo Eid-Lidt, Guering Eur Heart J Case Rep Case Report BACKGROUND: Ventricular septal defect (VSD) complicating acute myocardial infarction (MI) represents a life-threatening condition and has a mortality of >90% if left untreated. CASE SUMMARY: A 53-year-old man with a prior medical history of diabetes and hypertension presented with cardiogenic shock secondary to VSD as a mechanical complication of non-reperfused inferior MI. DISCUSSION: The choice of mechanical support can be difficult in this type of patient. Given the risk of an increased shunt because of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and the increase in left ventricle (LV) afterload, several measures were taken to plan the best ECMO configuration. Given the absence of any real improvement in the LV and an elevated residual ratio between pulmonary and systemic flow (Qp/Qs), the final decision was to switch to left atrial VA-ECMO (LAVA-ECMO). The use of LAVA-ECMO improved the patient’s haemodynamics and allowed his condition to stabilize; LAVA-ECMO is feasible and may be effective as a mechanical circulatory support (MCS) strategy for patients in cardiogenic shock due to VSD as a mechanical complication of acute MI. Oxford University Press 2023-08-16 /pmc/articles/PMC10456208/ /pubmed/37637096 http://dx.doi.org/10.1093/ehjcr/ytad393 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Case Report Jiménez-Rodríguez, Gian Manuel Rojas-Velasco, Gustavo Arias-Sánchez, Eduardo A Manzur-Sandoval, Daniel Vega-Servin, Norman Said Quirazco-Cordova, Ricardo-Eduardo Eid-Lidt, Guering Left atrial veno-arterial extracorporeal membrane oxygenation in post-myocardial infarction ventricular septal defect with cardiogenic shock: a case report |
title | Left atrial veno-arterial extracorporeal membrane oxygenation in post-myocardial infarction ventricular septal defect with cardiogenic shock: a case report |
title_full | Left atrial veno-arterial extracorporeal membrane oxygenation in post-myocardial infarction ventricular septal defect with cardiogenic shock: a case report |
title_fullStr | Left atrial veno-arterial extracorporeal membrane oxygenation in post-myocardial infarction ventricular septal defect with cardiogenic shock: a case report |
title_full_unstemmed | Left atrial veno-arterial extracorporeal membrane oxygenation in post-myocardial infarction ventricular septal defect with cardiogenic shock: a case report |
title_short | Left atrial veno-arterial extracorporeal membrane oxygenation in post-myocardial infarction ventricular septal defect with cardiogenic shock: a case report |
title_sort | left atrial veno-arterial extracorporeal membrane oxygenation in post-myocardial infarction ventricular septal defect with cardiogenic shock: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10456208/ https://www.ncbi.nlm.nih.gov/pubmed/37637096 http://dx.doi.org/10.1093/ehjcr/ytad393 |
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