Myocardial failure caused by traumatic dissection of left coronary system--ventricular recovery with temporary circulatory support.
We report a case of a patient suffering from massive myocardial infarction after traumatic dissection of the left coronary system. The dissection involved the left coronary artery including peripheral segments of the coronary circulation. The patient was revascularized; however, she could not be weaned from cardiopulmonary bypass thereafter. An Impella microaxial hemopump was implanted and the patient's left ventricular function markedly improved during the following days. Eight days later hemodynamics had stabilized far enough to explant the device, after explantation the patient remained hemodynamically stable and free of inotropic support. The report intends to emphasize the potential of the myocardium to recover even after extensive infarction under temporary ventricular support and takes the Impella microaxial hemopump into consideration as a device that is technically easy to implant with no injury to the ventricle and thus associated with good properties for weaning. Surgeons should consider the device as short-term support in borderline indications.
Lauten
Alexander
A
Department of Cardiothoracic and Vascular Surgery, Friedrich Schiller University Jena, Jena, Germany. alexlauten@gmx.de
Strauch
Justus T
JT
Groetzner
Jan
J
Wahlers
Thorsten
T
D000328:Adult; D000784:Aortic Dissection / Q000209:etiology / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D003323:Coronary Aneurysm / Q000209:etiology / Q000601:surgery*; D017023:Coronary Angiography / Q000009:adverse effects*; D001026:Coronary Artery Bypass; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006353:Heart-Assist Devices; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology