Veno-arterial mechanical support as bridge to surgery in a patient with severe aortic regurgitation: a case report

Perfusion ◽  
2020 ◽  
Vol 35 (7) ◽  
pp. 697-699
Author(s):  
Paolo Bianchi ◽  
Richard Trimlett ◽  
Tim Jackson ◽  
Toufan Bahrami ◽  
Nicholas James Lees
Keyword(s):  
Decision Making ◽  
Case Report ◽  
Extracorporeal Membrane Oxygenation ◽  
Pulmonary Oedema ◽  
Aortic Regurgitation ◽  
Mechanical Valve ◽  
Bridge To Surgery ◽  
Mechanical Support ◽  
Severe Aortic Regurgitation ◽  
Membrane Oxygenation

In this case report, we describe the successful application of veno-arterial extracorporeal membrane oxygenation support in a young patient with severe aortic regurgitation caused by a blocked mechanical valve. In this situation, extracorporeal membrane oxygenation mechanical support was used as a bridge to the prompt replacement of the diseased valve. Aortic regurgitation is commonly recognized as a contraindication to extracorporeal membrane oxygenation support because of the risk of ventricular distension, pulmonary oedema and further organ failure. However, in certain cases and with a rapid decision making, extracorporeal membrane oxygenation can be used as a bridge to treatment and recovery.

scholarly journals P0605 / #959: USE OF EXTRACORPOREAL MEMBRANE OXYGENATION SUPPORT DURING STAPHYLOCOCCUS AUREUS REFRACTORY SEPTIC SHOCK: A CASE REPORT FOR MECHANICAL SUPPORT

2021 ◽  
Vol 22 (Supplement 1 3S) ◽  
pp. 297-297
Author(s):  
J. Rodriguez Coronado ◽  
J. Saldivar Martinez ◽  
R. Gomez Gutierrez ◽  
G. Quezada Valenzuela ◽  
M. Contreras Cepeda ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Septic Shock ◽  
Case Report ◽  
Extracorporeal Membrane Oxygenation ◽  
Mechanical Support ◽  
Membrane Oxygenation ◽  
Refractory Septic Shock

scholarly journals Evolution into Takayasu arteritis in a patient presenting with acute pulmonary oedema due to severe aortic regurgitation; a case report

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Nipun Lakshitha de Silva ◽  
Milinda Withana ◽  
Praveen Weeratunga ◽  
Prakash Priyadharshana ◽  
Inoshi Atukorala
Keyword(s):  
Case Report ◽  
Pulmonary Oedema ◽  
Aortic Regurgitation ◽  
Takayasu Arteritis ◽  
Acute Pulmonary Oedema ◽  
Severe Aortic Regurgitation

Severe aortic valve regurgitation requiring mechanical aortic valve replacement following Impella device implantation

Perfusion ◽  
2020 ◽  
pp. 026765912094133
Author(s):  
Pierre Vila ◽  
Felicity de Vere ◽  
André Simon ◽  
Christopher Walker
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Extracorporeal Membrane Oxygenation ◽  
Cardiogenic Shock ◽  
Aortic Regurgitation ◽  
Valve Replacement ◽  
Myocardial Function ◽  
Severe Aortic Regurgitation ◽  
Membrane Oxygenation ◽  
Device Implantation

Introduction: We describe a patient who developed severe aortic regurgitation following Impella left ventricular assist device implantation requiring aortic valve replacement. Case report: A previously healthy 34-year-old female presented with chest pain and flu-like symptoms. Electrocardiogram showed widespread ST elevation and serum troponin was raised, consistent with myocarditis. Coronary angiography was normal but the right coronary artery dissected. Subsequent cardiogenic shock required veno-arterial extracorporeal membrane oxygenation and Impella implantation. Myocardial function recovered, but upon removal of the Impella, severe aortic regurgitation was present and she underwent aortic valve replacement, making a full recovery. Discussion: Aortic regurgitation is a rare complication of Impella implantation, and to our knowledge, this is the first reported case successfully treated with aortic valve replacement. Veno-arterial extracorporeal membrane oxygenation and Impella used in tandem are relatively novel, and may add synergistic benefit to strategies for acute cardiogenic shock. Conclusion: Echocardiography must include frequent assessment of both valvular and myocardial function after Impella removal.

scholarly journals Successful extracorporeal membrane oxygenation resuscitation of patient with cardiogenic shock induced by phaeochromocytoma crisis mimicking hyperthyroidism: A case report

2021 ◽  
Vol 16 (1) ◽  
pp. 746-751
Author(s):  
Tao Wang ◽  
Qiancheng Xu ◽  
Xiaogan Jiang
Keyword(s):  
Case Report ◽  
Extracorporeal Membrane Oxygenation ◽  
Cardiogenic Shock ◽  
Tumour Size ◽  
Acute Onset ◽  
Left Ventricular ◽  
Vanillylmandelic Acid ◽  
Membrane Oxygenation ◽  
First Case ◽  
Va Ecmo

Abstract A 29-year-old woman presented to the emergency department with the acute onset of palpitations, shortness of breath, and haemoptysis. She reported having an abortion (56 days of pregnancy) 1 week before admission because of hyperthyroidism diagnosis during pregnancy. The first diagnoses considered were cardiomyopathy associated with hyperthyroidism, acute left ventricular failure, and hyperthyroidism crisis. The young woman’s cardiocirculatory system collapsed within several hours. Hence, venoarterial extracorporeal membrane oxygenation (VA ECMO) was performed for this patient. Over the next 3 days after ECMO was established, repeat transthoracic echocardiography showed gradual improvements in biventricular function, and later the patient recovered almost completely. The patient’s blood pressure increased to 230/130 mm Hg when the ECMO catheter was removed, and then the diagnosis of phaeochromocytoma was suspected. Computed tomography showed a left suprarenal tumour. The tumour size was 5.8 cm × 5.7 cm with central necrosis. The vanillylmandelic acid concentration was 63.15 mg/24 h. Post-operation, pathology confirmed phaeochromocytoma. To our knowledge, this is the first case report of a patient with cardiogenic shock induced by phaeochromocytoma crisis mimicking hyperthyroidism which was successfully resuscitated by VA ECMO.

scholarly journals Percutaneous left atrial unloading to prevent pulmonary oedema and to facilitate ventricular recovery under extracorporeal membrane oxygenation therapy

2017 ◽  
Vol 26 (1) ◽  
pp. 4-7 ◽  
Author(s):  
Alexander M Bernhardt ◽  
Mathias Hillebrand ◽  
Yalin Yildirim ◽  
Samer Hakmi ◽  
Florian M Wagner ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Pulmonary Oedema ◽  
Left Atrial ◽  
Membrane Oxygenation

scholarly journals Case Report. Extracorporeal Membrane Oxygenation in Nivolumab Associated Pneumonitis

2017 ◽  
Vol 3 (2) ◽  
pp. 84-88
Author(s):  
Thomas-Michael Schneider ◽  
Friederike Klenner ◽  
Franz Brettner
Keyword(s):  
Case Report ◽  
Extracorporeal Membrane Oxygenation ◽  
Therapeutic Option ◽  
High Dose ◽  
Great Success ◽  
Case Presentation ◽  
Computed Tomographic ◽  
Rehabilitation Hospital ◽  
Membrane Oxygenation ◽  
History Of

Abstract Background: Newly approved immunotherapeutic agents, like CTLA-4 inhibitors and antibodies against PD-1, are a promising therapeutic option in cancer therapy. Case presentation: A 74-year-old man, with a history of advanced stage melanoma and treatment with ipilimumab, pembrolizumab and nivolumab, was admitted to the hospital due to respiratory failure with hypoxemia and dyspnoea. He rapidly developed severe acute respiratory distress syndrome (ARDS), which required treatment in the intensive care unit which included mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Computed tomographic imaging (CT) showed signs of a pneumonitis, with an ARDS pattern related to the use of PD-1 antibodies. Treating the patient with high-dose immunosuppressive steroids led to an overall improvement. He was transferred to a rehabilitation hospital and subsequently to his home. Discussion and conclusion: This is a unique case report of a patient suffering a grade 4 adverse event under nivolumab who survived having been treated with ECMO. It highlights the possibility of associated adverse reactions as well as the use of ECMO in palliative care patients. ECMO can be of great success even in patients with malignancies, but careful decision making should be done on a case by case basis.

Sign in / Sign up

Export Citation Format

Share Document