Percutaneous cardiopulmonary support in refractory no-reflow with cardiogenic shock after coronary stenting in acute myocardial infarction.
Coronary no-reflow is defined as inadequate myocardial perfusion of a given coronary segment without angiographic evidence of mechanical vessel obstruction. No-reflow is visualized angiographically as a reduction in thrombolysis in myocardial infarction (TIMI) flow grade and is typically accompanied by chest pain, electrocardiographic changes with ST-segment shift and possible hemodynamic compromise. No-reflow during primary percutaneous coronary intervention (PCI) results in increasing mortality and morbidity. Therefore, treatment of noreflow is associated with improved clinical outcomes. Generally, the treatment of no-reflow is based on pharmacotherapy. In this case, despite maximal pharmacotherapy and intraaortic balloon pump (IABP), refractory no-reflow accompanied with cardiogenic shock was successfully treated with percutaneous cardiopulmonary support (PCPS).
Son
Jung-Woo
JW
Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea.
Kim
Jin-Sun
JS
Lee
Jung Myung
JM
Hong
Sung Jin
SJ
Jung
Min Kyu
MK
Kim
Duk-Hwan
DH
Kim
Jung-Sun
JS
Choi
Donghoon
D
Jang
Yangsoo
Y
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D012770:Shock, Cardiogenic / Q000628:therapy*; D015607:Stents / Q000009:adverse effects*