Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):681-687 | DOI: 10.5507/bp.2015.044

Refractory cardiogenic shock due to extensive anterior STEMI with covered left ventricular free wall rupture treated with awake VA-ECMO and LVAD as a double bridge to heart transplantation - collaboration of three cardiac centres

Jan Kacera, Michaela Lindovskaa, Roman Surovcika, Ivan Netukab,c, Frantisek Mlejnskyc, Tomas Grusc, Jan Belohlavekd
a Department of Cardiology, Bulovka Hospital, Prague, Czech Republic
b Cardiovascular Surgery Department, IKEM, Prague
c 2nd Department of Surgery, Cardiovascular Surgery, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague
d 2nd Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague

Aim: To highlight an optimal collaborative strategy of three different levels of specialized care cardiac centres.

Background: Refractory cardiogenic shock is a life-threatening condition. A myocardial recovery is not achieved in many cases despite all efforts and subsequently the heart transplantation remains an ultimate option. Thereby, the use of extracorporeal membrane oxygenation (ECMO) followed by a ventricular assist device in staged bridging provides an attractive approach.

Case report: We report on an optimal cooperation of PCI (percutaneous coronary intervention) centre with ELSO (extracorporeal life support organization) centre and transplant centre in a patient suffering from refractory cardiogenic shock due to acute myocardial infarction (RCSMI) complicated by left ventricle free wall rupture with pericardial tamponade.

Conclusion: The interhospital collaboration can be essential in the context of patients with RCSMI. The use of ECMO enables safe interhospital transport and gains time for further diagnostic and therapeutic steps in such critically ill patients.

Keywords: refractory cardiogenic shock in acute myocardial infarction, percutaneous coronary intervention, extracorporeal membrane oxygenation, left ventricle assist device

Received: April 9, 2015; Accepted: September 10, 2015; Prepublished online: October 23, 2015; Published: December 3, 2015  Show citation

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Kacer, J., Lindovska, M., Surovcik, R., Netuka, I., Mlejnsky, F., Grus, T., & Belohlavek, J. (2015). Refractory cardiogenic shock due to extensive anterior STEMI with covered left ventricular free wall rupture treated with awake VA-ECMO and LVAD as a double bridge to heart transplantation - collaboration of three cardiac centres. Biomedical papers, 159(4), 681-687. doi: 10.5507/bp.2015.044
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