Emergency cardiopulmonary bypass support in patients with severe cardiogenic shock after acute myocardial infarction.
A total of 16 patients who developed severe cardiogenic shock were resuscitated with a percutaneous cardiopulmonary support system (PCPS). The etiology of shock was acute myocardial infarction (n = 7), or post-infarction left-ventricular (LV) free wall rupture (n = 9). After successful resuscitation with the PCPS, 15 patients underwent therapeutic interventions: closure of an LV rupture (n = 9), coronary artery bypass grafting (n = 4), percutaneous transluminal angioplasty (n = 1), and percutaneous transluminal coronary recanalization (n = 1). Of the 16 patients, 14 were weaned from PCPS or standard cardiopulmonary bypass. Six patients survived longer than 30 days, 3 (19 percent) of whom were discharged from the hospital. The long-term survival rate in the 6 patients who underwent coronary revascularization was 33 percent (2/6). Of the 9 patients with LV free wall rupture, 1 was discharged from the hospital. Even though it cannot be concluded, from this small number of patients, that cardiopulmonary resuscitation using PCPS improves survival, it appears that PCPS is a powerful resuscitative modality for seriously ill patients with acute myocardial infarction or LV rupture.
Matsuwaka
R
R
Divisions of Cardiovascular Surgery, Cardiovascular Center, Osaka Police Hospital, Japan.
Sakakibara
T
T
Shintani
H
H
Yagura
A
A
Masai
T
T
Hirayama
A
A
Kodama
K
K
D000368:Aged; D000369:Aged, 80 and over; D002315:Cardiopulmonary Bypass; D002423:Cause of Death; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D006342:Heart Rupture, Post-Infarction / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D012770:Shock, Cardiogenic / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D015996:Survival Rate