Percutaneous right ventricular assist via the internal jugular vein in cardiogenic shock complicating an acute inferior myocardial infarction.
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.
Kiernan
Michael S
MS
Tufts Medical Center, Division of Cardiology, Boston, MA 02111, USA.
Krishnamurthy
Barath
B
Kapur
Navin K
NK
D054058:Acute Coronary Syndrome / Q000150:complications / Q000628:therapy; D006333:Heart Failure / Q000150:complications / Q000628:therapy; D006353:Heart-Assist Devices; D006801:Humans; D007601:Jugular Veins; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D019919:Prosthesis Implantation / Q000379:methods*; D012770:Shock, Cardiogenic / Q000150:complications* / Q000628:therapy*