[A successful case report of emergency coronary artery bypass grafting for left main trunk obstruction with profound cardiogenic shock: bridge use of balloon pumping and percutaneous cardiopulmonary support system to surgical intervention].
A 73-year-old man was admitted for sudden onset of dyspnea with cardiogenic shock. Chest X-P showed bilateral severe pulmonary edema. Echocardiogram demonstrated diffuse severe hypokinesis of left ventricle. Emergency coronary angiography showed 99% stenosis of left main trunk with delay. After insertion of intraaortic balloon pump (IABP) and percutaneous cardiopulmonary support system (PCPS), vital signs and consciousness were improved. Emergency coronary artery bypass grafting (CABG) was performed, LIMA to left anterior descending artery, saphenous vein grafts to circumflex and right coronary artery. Left ventricular wall motion was improved after bypass grafting and cardiopulmonary bypass was weaned with catecholamine and IABP support. The patient was discharged from hospital 60 days after the operation with good cardiac function. We emphasized a usefulness of combined use of IABP and PCPS to provide systemic organ perfusion and reduce myocardial infarct size and ischemic damages after re-vascularization for coronary insufficiency with profound shock.
Suenaga
E
E
Department of Thoracic and Cardiovascular Surgery, Fukuoka Tokusyukai Hospital, Kasuga, Japan.
Minato
N
N
Murayama
J
J
Rikitake
K
K
D000368:Aged; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D004630:Emergencies; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D009203:Myocardial Infarction / Q000150:complications / Q000628:therapy*; D012770:Shock, Cardiogenic / Q000209:etiology*