ECPELLA as the bridge to surgery in patients with cardiogenic shock due to post-infarct papillary muscle rupture: management of mechanical circulatory support during operation.
Kazuyoshi TakagiTakahiro ShojimaTakanori KonoSatoshi KikusakiTakehiro HommaTatsuhiro ShibataMaki OtsukaYoshihiro FukumotoEiki TayamaPublished in: Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs (2022)
Papillary muscle rupture is a fatal complication with a high operative mortality. Most patients experience cardiogenic shock and hypoxia due to pulmonary edema caused by severe mitral regurgitation. Although preoperative stabilization using a mechanical assist device potentially improves surgical outcomes, an appropriate strategy has not yet been established. ECPELLA, combining venoarterial extracorporeal membrane oxygenation and Impella, has the potential to stabilize preoperative status and improve outcome in patients with refractory cardiogenic shock due to papillary muscle rupture. Herein, we present 3 cases involving the efficacy of ECPELLA and our tips of surgical and ECPELLA management in patients with papillary muscle rupture.
Keyphrases
- extracorporeal membrane oxygenation
- acute respiratory distress syndrome
- skeletal muscle
- clear cell
- respiratory failure
- end stage renal disease
- patients undergoing
- ejection fraction
- newly diagnosed
- pulmonary hypertension
- chronic kidney disease
- prognostic factors
- acute myocardial infarction
- early onset
- heart failure
- cardiovascular events
- cardiovascular disease
- peritoneal dialysis
- intensive care unit
- endothelial cells
- patient reported outcomes
- atrial fibrillation
- drug induced