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Emergency cardiopulmonary bypass support in patients with severe cardiogenic shock after acute myocardial infarction

Summary

A total of 16 patients who developed severe cardiogenic shock were resuscitated with a percutaneous cardiopulmonary support system (PCPS). The etiology of shock was acute myocardial infarction (n = 7), or post-infarction left-ventricular (LV) free wall rupture (n = 9). After successful resuscitation with the PCPS, 15 patients underwent therapeutic interventions: closure of an LV rupture (n = 9), coronary artery bypass grafting (n = 4), percutaneous transluminal angioplasty (n = 1), and percutaneous transluminal coronary recanalization (n = 1). Of the 16 patients, 14 were weaned from PCPS or standard cardiopulmonary bypass. Six patients survived longer than 30 days, 3 (19%) of whom were discharged from the hospital. The long-term survival rate in the 6 patients who underwent coronary revascularization was 33% (2/6). Of the 9 patients with LV free wall rupture, 1 was discharged from the hospital. Even though it cannot be concluded, from this small number of patients, that cardiopulmonary resuscitation using PCPS improves survival, it appears that PCPS is a powerful resuscitative modality for seriously ill patients with acute myocardial infarction or LV rupture.

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Correspondence to Ryousuke Matsuwaka.

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Matsuwaka, R., Sakakibara, T., Shintani, H. et al. Emergency cardiopulmonary bypass support in patients with severe cardiogenic shock after acute myocardial infarction. Heart Vessels 11, 27–29 (1996). https://doi.org/10.1007/BF01744596

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Key words

  • Percutaneous cardiopulmonary bypass
  • Acute myocardial infarction
  • Cardiac arrest