PMID: 20124598Feb 4, 2010Paper

Percutaneous right ventricular assist via the internal jugular vein in cardiogenic shock complicating an acute inferior myocardial infarction

The Journal of Invasive Cardiology
Michael S KiernanNavin K Kapur

Abstract

Management of right heart failure in acute myocardial infarction (AMI) includes emergent reperfusion of the infarct-related artery, fluid resuscitation, vasopressor and inotropic support, and trans-venous pacing in the presence of high-grade atrio-ventricular conduction block. Historically, mechanical support for right ventricular failure after an AMI has been limited to intra-aortic balloon pump (IABP) counterpulsation or surgically placed ventricular assist devices. Recently, a percutaneous right ventricular assist device (pRVAD, TandemHeart; CardiacAssist Inc., Pittsburgh, Pennsylvania) has offered an intermediate alternative for patients with refractory right heart failure in the setting of AMI. We describe a novel approach to pRVAD implantation via the right internal jugular vein in the setting of cardiogenic shock secondary to an acute inferior myocardial infarction.

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