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

Should off-pump CABG be favoured for redo myocardial revascularization?

2010 ◽  
Vol 58 (S 01) ◽  
Author(s):  
S Sadoni ◽  
E Trifan ◽  
I Kaczmarek ◽  
F Vogt ◽  
B Reichart ◽  
...  
Keyword(s):  
Myocardial Revascularization ◽  
Off Pump ◽  
Pump Cabg

Exclusive Bilateral Internal Thoracic Artery Grafts for Myocardial Revascularization Requiring Four Anastomoses or More: Outcomes from a Single Center Experience

2016 ◽  
Vol 65 (04) ◽  
pp. 265-271
Author(s):  
Andrea Perrotti ◽  
Enrica Dorigo ◽  
Camille Durst ◽  
Djamel Kaili ◽  
Sidney Chocron ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Internal Thoracic Artery ◽  
Artery Bypass ◽  
Univariate Analysis ◽  
Bypass Graft ◽  
Myocardial Revascularization ◽  
Wound Complication ◽  
Safe Procedure ◽  
Off Pump

Introduction Multivessel coronary artery bypass graft (CABG) with bilateral internal thoracic arteries (BITA) has only been uncommon and technically demanding. We describe our experience with BITA only CABGs requiring ≥ 4 anastomoses. Material and Methods The department's database was queried for patients undergoing isolated CABG with ≥ 4 anastomoses. The surgical technique included systematically a right internal thoracic artery (ITA) of left ITA Y graft. The multivariate model included variables with a p < 0.3 at univariate analysis. Results Between January 2006 and December 2009, 251 consecutive patients (71 ± 10 years) (on-pump: 130, off-pump: 121) had CABG with ≥ 4 anastomoses, representing 21% of total isolated CABGs for the same period; all patients received a totally arterial BITA only revascularization. Follow-up was 4.9 ± 1.6 years. Overall and cardiac cumulative survivals were 78 and 92%, respectively, at 5 years. The occurrence of any major postoperative complication was associated with overall and cardiac mortality (odds ratio [OR]: 3.6, 95% confidence interval [CI]: 1.3–9.9 and OR: 5.4, 95% CI: 1.3–21.9, respectively). Major sternal wound complication requiring surgical revision was not associated with impaired glucose control (n = 9; diabetics: 6/82, 7.3%; nondiabetics: 3/169, 1.8%, p = 0.06). Preoperative kidney failure was associated with incomplete revascularization (OR: 6.2; 95% CI: 1.2–33.5), that was unfailingly due to ungraftable right coronary artery targets. Discussion BITA only revascularization was a valuable and safe procedure, with favorable results in terms of morbidity and mortality at a 5 years' follow-up.

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 Coronary Endarterectomy with off Pump Coronary Artery Bypass Surgery- A Review

2017 ◽  
Vol 10 (1) ◽  
pp. 84-90
Author(s):  
Redoy Ranjan ◽  
Dipannita Adhikary ◽  
Heemel Saha ◽  
Sanjoy Kumar Saha ◽  
Sabita Mandal ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Myocardial Revascularization ◽  
Graft Patency ◽  
Coronary Endarterectomy ◽  
Off Pump ◽  
Diffuse Coronary Artery Disease ◽  
Artery Disease ◽  
Pump Coronary Artery Bypass

Coronary endarterectomy is first described as an alternative surgical procedure for myocardial revascularization against diffuse coronary artery disease by Baily et al. in 1956. Coronary endarterectomy provides complete surgical revascularization of the myocardium in diffuse and calcified coronary arteries with adequate blood flow to distal part of occluded arteries, thus improving ventricular function. However, the initial outcomes of coronary endarterectomy were not satisfactory but now-a-days different studies have shown that coronary endarterectomy with coronary artery bypass grafting can be done safely with acceptable morbidity and mortality. Moreover, the graft patency rate on angiographic evaluation is also good following coronary endarterectomy. So, it’s time to reevaluate this old techniques, and reanalysis the current outcomes of coronary endarterectomy and readdress its indication in diffuse coronary artery diseaseCardiovasc. j. 2017; 10(1): 84-90

Peripheral VA-ECMO with direct biventricular decompression for refractory cardiogenic shock

Perfusion ◽  
2018 ◽  
Vol 33 (6) ◽  
pp. 493-495 ◽  
Author(s):  
Prashant Rao ◽  
Jarrod Mosier ◽  
Joshua Malo ◽  
Vicky Dotson ◽  
Christopher Mogan ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Extracorporeal Membrane Oxygenation ◽  
Cardiogenic Shock ◽  
Mortality Rates ◽  
Left Ventricular ◽  
Off Pump ◽  
Novel Technique ◽  
Refractory Cardiogenic Shock ◽  
Life Threatening ◽  
Va Ecmo

Cardiogenic shock and cardiac arrest are life-threatening emergencies that result in high mortality rates. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) via peripheral cannulation is an option for patients who do not respond to conventional therapies. Left ventricular (LV) distention is a major limitation with peripheral VA-ECMO and is thought to contribute to poor recovery and the inability to wean off VA-ECMO. We report on a novel technique that combines peripheral VA-ECMO with off-pump insertion of a trans-apical LV venting cannula and a right ventricular decompression cannula.

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