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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

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  • Artificial Heart (Clinical)
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Abstract

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.

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Authors and Affiliations

  1. Division of Cardiovascular Surgery, Department of Surgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, 830-0011, Japan

    Kazuyoshi Takagi, Takahiro Shojima, Takanori Kono, Satoshi Kikusaki & Eiki Tayama

  2. Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan

    Takehiro Homma, Tatsuhiro Shibata, Maki Otsuka & Yoshihiro Fukumoto

Authors
  1. Kazuyoshi Takagi
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  2. Takahiro Shojima
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  3. Takanori Kono
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  4. Satoshi Kikusaki
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  5. Takehiro Homma
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  6. Tatsuhiro Shibata
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  7. Maki Otsuka
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  8. Yoshihiro Fukumoto
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  9. Eiki Tayama
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Correspondence to Kazuyoshi Takagi.

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Written informed consent was obtained from all patients. This study was approved by the institutional ethics committee (Kurume University IRB No.: 2020 103).

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Takagi, K., Shojima, T., Kono, T. et al. 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. J Artif Organs 26, 237–241 (2023). https://doi.org/10.1007/s10047-022-01365-w

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  • DOI: https://doi.org/10.1007/s10047-022-01365-w

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