Emergent TandemHeart-ECMO for acute severe mitral regurgitation with cardiogenic shock and hypoxaemia: a case series

European Heart Journal. Case Reports
Michael DiVitaMark J Zucker

Abstract

Acute severe mitral regurgitation (MR) associated with cardiogenic shock is a life-threatening emergency. Traditional teaching has focused on the need for emergent coronary angiography and/or intra-aortic balloon counterpulsation in preparation for emergent open-heart surgery for repair/replacement. Unfortunately, emergent open-heart surgery in patients with acute MR complicated by cardiogenic shock is associated with 25-46% perioperative mortality. New devices have provided additional options for stabilization prior to emergent surgery which facilitate improved outcomes. We present two cases of acute severe MR resulting in cardiogenic shock and profound hypoxaemia. TandemHeart® mechanical circulatory support with an oxygenator spliced into the circuit, akin to veno-arterial extracorporeal membrane oxygenation (ECMO), facilitated haemodynamic stabilization and decongestion of the lungs facilitating successful bridge to mitral valve surgery. Successful discharge to home was achieved in both patients with good neurological outcomes and sustained long-term functional recovery at 18 and 14 months, respectively. Selective use of the TandemHeart®, with or without ECMO, facilitates management of the critically ill cardiogenic shock pa...Continue Reading

References

Mar 4, 2008·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Roberto LorussoAndrea Sala
Nov 26, 2008·Circulation·William H Gaasch, Theo E Meyer
Aug 3, 2013·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Ravi S HiraBiswajit Kar

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Citations

Mar 23, 2021·Interventional Cardiology Clinics·Pedro VillablancaWilliam W O'Neill
Jun 16, 2021·Circulation·Abdulla A DamlujiUNKNOWN American Heart Association Council on Clinical Cardiology; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Cou

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Methods Mentioned

BETA
X-ray
saphenous
coronary artery bypass

Software Mentioned

TandemHeart

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Cardiogenic Shock

Cardiogenic shock is a devastating consequence of acute myocardial infarction and is associated with an extremely high mortality. Here is the latest research.

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