Aggressive Myocardial Revascularization Strategies Improve Survival Following Cardiogenic Shock

1998 ◽  
Vol 31 (2) ◽  
pp. 290A-291A
Author(s):  
M Nahlawi
Keyword(s):  
Cardiogenic Shock ◽  
Myocardial Revascularization

Salvage myocardial revascularisation in spontaneous left main coronary artery dissection with cardiogenic shock – the role of mechanical circulatory support

Perfusion ◽  
2016 ◽  
Vol 32 (2) ◽  
pp. 171-173 ◽  
Author(s):  
Ashok Padukone ◽  
Ahmed K. Sayeed ◽  
Nandor Marczin ◽  
Diana García Sáez ◽  
Bartlomiej Zych ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Cardiogenic Shock ◽  
Mechanical Circulatory Support ◽  
Left Main Coronary Artery ◽  
Artery Bypass ◽  
Myocardial Revascularization ◽  
Circulatory Support ◽  
Artery Dissection ◽  
Left Main ◽  
Coronary Artery Dissection

Spontaneous left main coronary artery dissection is a rare cause of acute coronary events or sudden cardiac death, constituting less than 1% of all epicardial coronary artery dissections. It is often fatal and is mostly recognized at post-mortem examination in young victims of sudden death. More than 70% of the reported cases occurred in women, particularly during pregnancy and the peripartum period and those on oral contraceptives. The clinical presentation is highly variable and prognosis varies widely, depending predominantly on the speed of diagnosis. Treatment options include medical therapy, revascularization with coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) and mechanical circulatory support in cases of cardiogenic shock. We report a case of spontaneous dissection of the left main stem coronary artery, with extension into the left coronary territory, which occurred in a 41-year-old lady, complicated by profound cardiogenic shock requiring recovery with extracorporeal mechanical circulatory support after salvage myocardial revascularization.

scholarly journals PILOT RESULTS OF STUDYING CARDIAC MICROPOTENTIALS IN PATIENTS WITH MYOCARDIAL INFARCTION AND CARDIOGENIC SHOCK

2019 ◽  
Vol 33 (4) ◽  
pp. 103-110 ◽  
Author(s):  
I. V. Maximov ◽  
D. K. Avdeeva ◽  
M. L. Ivanov ◽  
I. A. Zimin ◽  
M. M. Yuzhakov ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Pilot Study ◽  
High Resolution ◽  
Cardiogenic Shock ◽  
Myocardial Revascularization ◽  
Left Ventricular ◽  
National Guidelines ◽  
Software Complex ◽  
Heart Rhythm Disorders ◽  
Life Threatening

Aim. To study cardiac micropotentials registered by the hardware and software complex with nanosensors in patients with myocardial infarction for the early detection of life-threatening conditions.Materials and Methods. The pilot study included 29 patients with acute myocardial infarction who had life-threatening complications such as heart rhythm disorders, the development of acute left ventricular failure, or clinical death prehospitally or at admission to the coronary care unit. The diagnosis of myocardial infarction was established and treatment was carried out according to the national guidelines for the management of patients with myocardial infarction, including the methods of myocardial revascularization.Results. During hospitalization, eight patients developed cardiogenic shock and died. 21 patients survived and were included in the comparison group. At admission, all patients underwent high-resolution electrocardiography using the originally developed hardware and software complex with nanosensors. The micropotentials on the ST segment of the electrocardiogram were recorded for 30 s in three leads on-line. The numbers of micropotentials in the studied groups were analyzed. The analysis of the number of micropotentials within certain ranges of amplitude and duration registered on high-resolution electrocardiogram showed a decrease of the micropotential number in group of patients who died from cardiogenic shock compared with the group of survived patients.Conclusions. The results of this pilot study of cardiac micropotentials are preliminary and require further accumulation of data as well as a search for new criteria for diagnostics, prognosis, and evaluation of the treatment efficacy in patients with myocardial infarction.

scholarly journals Complete percutaneous myocardial revascularization in patients with STEMI complicated by cardiogenic shock

2019 ◽  
Vol 76 (2) ◽  
pp. 152-160
Author(s):  
Milovan Petrovic ◽  
Milana Jarakovic ◽  
Milenko Cankovic ◽  
Ilija Srdanovic ◽  
Mila Kovacevic ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Cardiogenic Shock ◽  
Myocardial Revascularization ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Vessel Disease ◽  
Early Revascularization ◽  
Infarct Related Artery

Background/Aim. Despite considerable progress in terms of early myocardial revascularization and the use of mechanical circulatory support, cardiogenic shock continues to be the leading cause of death in acute myocardial infarction. The current recommendations of the European Society of Cardiology advocate early revascularization of all critical stenosis or highly unstable lesions in the state of cardiogenic shock, while recently published studies favour the early revascularization of the infarct related artery only, in patients with acute myocardial infarction with the ST segment elevation (STEMI) presenting with cardiogenic shock. The aim of the study was to assess the impact of the complete early percutaneous myocardial revascularization in an acute myocardial infarction complicated by cardiogenic shock on intra- hospital mortality. Methods. The research was conducted as a retrospective observational analysis of data obtained from the hospital registry for cardiogenic shock. The study group consisted of 235 patients treated in the period from August 2007 until October 2016 for STEMI complicated by cardiogenic shock. Three groups were formed. The first group consisted of patients with one vessel disease who underwent revascularization of infarct related artery; the second group of patients had multi-vessel disease and only culprit lesions were revascularized and the third one consisted of patients with multi-vessel disease and the complete myocardial revascularization performed. Additional subgroups were formed in reference to the intra-aortic balloon pump (IABP) implantation. Intra-hospital mortality was analyzed in all groups and subgroups. Results. Revascularization of the culprit lesion alone among patients with multivessel disease was performed in 142 (60.4%) patients while the complete revascularization (revascularization of ?culprit? and other significant lesions) was performed in 28 (11.9%) patients with multi-vessel disease. There were 65 (27.7%) patients with single-vessel disease who underwent revascularization of infarct related artery. The lowest mortality was found in the group of patients with multi-vessel coronary disease who underwent complete myocardial revascularization and had IABP implanted (mortality was 35.7%). The difference in the mean value of the left ventricular ejection fraction (EF) between the surviving and deceased patients was statistically significant (p < 0.005). The average EF of survivors was 44% (35%?50%) while 30% (25%?39.5%) deceased of patients. Based on the obtained data, the mathematically predictive model was tested. The receiver operating characteristic (ROC) curve showed that our model is a good predictor of fatal outcome (p < 0.0005; AUROC = 0.766) with the sensitivity of 80.3%, and the specificity of 67%. Conclusion. STEMI complicated by cardiogenic shock is still associated with a high mortality rate. Complete myocardial revascularization independently as well as in combination with an IABP, significantly reduces mortality in patients with acute STEMI complicated by cardiogenic shock.

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

2021 ◽  
pp. 34-41
Author(s):  
B. M. Todurov ◽  
O. A. Loskutov ◽  
O. M. Druzhina ◽  
H. I. Kovtun ◽  
S. R. Maruniak
Keyword(s):  
Myocardial Infarction ◽  
Extracorporeal Membrane Oxygenation ◽  
Cardiogenic Shock ◽  
Mechanical Circulatory Support ◽  
Myocardial Revascularization ◽  
Coronary Intervention ◽  
Circulatory Support ◽  
Membrane Oxygenation ◽  
Percutaneous Coronary ◽  
Risk Patients

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.

Off‐pump myocardial revascularization with Impella 5.5‐assisted for cardiogenic shock

2021 ◽  
Author(s):  
Giuseppe Tavilla ◽  
Daniel L. Beckles ◽  
Phillip Morris ◽  
Ramachandra C. Reddy
Keyword(s):  
Cardiogenic Shock ◽  
Myocardial Revascularization ◽  
Off Pump

scholarly journals Intra-aortic balloon pump in cardiogenic shock: state of the art

2017 ◽  
Vol 44 (1) ◽  
pp. 102-106 ◽  
Author(s):  
PETRONIO GENEROSO THOMAZ ◽  
LEONEL ADELINO MOURA JÚNIOR ◽  
GIOVANA MURAMOTO ◽  
RENATO SAMY ASSAD
Keyword(s):  
Cardiogenic Shock ◽  
Myocardial Revascularization ◽  
Heart Association ◽  
Primary Objective ◽  
Clinical Indication ◽  
Shock State ◽  
Low Cardiac Output ◽  
Intra Aortic Balloon Pump ◽  
Definition Of ◽  
European Society Of Cardiology

ABSTRACT The clinical definition of cardiogenic shock is that of a low cardiac output and evidence of tissue hypoxia in the presence of adequate blood volume. Cardiogenic shock is the main cause of death related to acute myocardial infarction (AMI), with a mortality rate of 45-70% in the absence of aggressive and highly specialized technical care. The intra-aortic balloon pump (IABP) is one of the most widely used mechanical assisting devices. During the last two decades, about 42% of patients with AMI who evolved with cardiogenic shock received mechanical circulatory assistance with IABP. Its clinical indication has been based on non-randomized studies and registry data. Recent studies have shown that the use of IABP did not reduce 30-day mortality in patients with AMI and cardiogenic shock treated with the strategy of early myocardial revascularization as the planned primary objective. The guidelines of the American Heart Association and of the European Society of Cardiology have reassessed their recommendations based on the results of meta-analyzes, including the IABP-SCHOCK II Trial study, which did not evidence an increase in survival of patients who received mechanical support with IABP. This review article addresses the clinical impact of IABP use in the cardiogenic shock caused by AMI.

scholarly journals P4653Complete myocardial revascularization in patients with STEMI complicated by cardiogenic shock

2017 ◽  
Vol 38 (suppl_1) ◽  
Author(s):  
M. Petrovic ◽  
M. Cankovic ◽  
M. Jarakovic ◽  
D. Tesic ◽  
T. Plavsic ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Myocardial Revascularization
Sign in / Sign up

Export Citation Format

Share Document