title: Prolonged left ventricular unloading prior to revascularization in cardiogenic shock associated with complete ventricular recovery.
abstract: The use of percutaneous mechanical circulatory support (MCS) in high-risk coronary intervention and cardiogenic shock is associated with improved ability to obtain complete revascularization. However, whether prolonged left ventricular unloading and mechanical circulatory support prior to coronary revascularization in acute myocardial infarct patients improves outcomes is unclear. We report a case in which a patient with acute anterior myocardial infarction and cardiogenic shock received prolonged left ventricular mechanical unloading for 24h prior to revascularization, and ultimately this resulted in a limited myocardial infarct and complete restoration of left ventricular function.
authors.affiliation: Division of Cardiovascular Medicine, Sulpizio Cardiovascular Center, University of California, San Diego, (also the institution where work was performed) La Jolla, CA 92037.
authors.forename: Praneet
authors.initials: P
authors.lastname: Mylavarapu
authors.affiliation: Division of Cardiovascular Medicine, Sulpizio Cardiovascular Center, University of California, San Diego, (also the institution where work was performed) La Jolla, CA 92037.
authors.forename: Ehtisham
authors.initials: E
authors.lastname: Mahmud
authors.affiliation: Division of Cardiovascular Medicine, Sulpizio Cardiovascular Center, University of California, San Diego, (also the institution where work was performed) La Jolla, CA 92037. Electronic address: mpatel@ucsd.edu.
authors.forename: Mitul P
authors.initials: MP
authors.lastname: Patel
mesh_terms: D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology / Q000601:surgery; D006353:Heart-Assist Devices; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000379:methods; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology; D015428:Myocardial Reperfusion Injury / Q000601:surgery*; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: Delayed myocardial reperfusion; Myocardial contrast echocardiography; Percutaneous coronary intervention; Ventricular assist device