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Myocardial revascularization in a patient with acute myocardial infarction, refractory shock and arrest supported by ECMO-VA


Journal of Cardiology & Current Research
Rodrigo Freire Bezerra,1 Rodrigo Moreira Castro,1 Douglas Rossoni,1 Débora Pereira de Aragão,1 Juliana Torres Pacheco,1 André Luis Valera Gasparoto,2 Anita L R Saldanha,3 Ana Paula Pantoja Margeotto,3 Tania Leme da Rocha Martinez3

Abstract

Extracorporeal membrane oxygenation is an extracorporeal life support modality that allows temporary support for pulmonary and/or cardiac function failure, refractory to conventional clinical treatment. Its indications include in-hospital cardiac arrest, refractory cardiogenic shock, and acute respiratory distress syndrome. Objective: This study will present the case of a 54-year-old patient with acute myocardial infarction plus diabetes, hypertension and heart failure with an ejection fraction of 31. This patient presented triarterial coronary lesions of over 80% of obstruction in three epicardial arteries. The patient was submitted to revascularization, who evolved with refractory cardiogenic shock due to important left ventricular dysfunction and opted for the installation of circulatory support with extracorporeal membrane oxygenation during cardiorespiratory arrest, as a bridge to the surgical approach. In the present case, arterial extracorporeal membrane oxygenation fulfilled its role as a bridge to definitive surgery, however, due to the negative direct contribution of other factors, the patient did not present a desired outcome.

Keywords

ECMO-VA, Revascularization, Cardiac Arrest, Refractory schock, Acute Myocardial Infarction

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