10 Feb 2021
Entrapment of the Impella heart pump in the mitral subvalvular apparatus
EuroIntervention Journal
A 47-year-old man presented with witnessed out-of-hospital cardiac arrest at his wedding and anterior ST-elevation myocardial infarction. Initial blood pressure was 90/60 mmHg with pulse of 115 beats/minute...
A 47-year-old man presented with witnessed out-of-hospital cardiac arrest at his wedding and anterior ST-elevation myocardial infarction. Initial blood pressure was 90/60 mmHg with pulse of 115 beats/minute. Coronary angiography showed 100% thrombotic occlusion of the proximal left anterior descending artery with Thrombolysis In Myocardial Infarction (TIMI) 0 flow, 90% disease in the proximal first diagonal, 80% disease in the small-calibre obtuse marginal-1, and 90% disease in the non-dominant mid right coronary artery.
Aspiration thrombectomy was performed with the Pronto® LP Extraction Catheter (Teleflex, Inc., Wayne, PA, USA), restoring sluggish flow. A 3.0×38 mm XIENCE (Abbott Vascular, Santa Clara, CA, USA) drug-eluting stent was deployed, establishing TIMI 3 flow. Haemodynamic support was provided with intra-aortic balloon counterpulsation and dopamine infusion. The patient developed significant hypoxaemia and pulmonary oedema requiring intubation, mechanical ventilation, and intravenous furosemide. Because of refractory cardiogenic shock, the patient was transferred to our hospital for advanced mechanical support...
Authors
N. Khalid, E. Shlofmitz, B.C. Case, R. Waksman
