Resumen de ECMELLA: Uso combinado de dispositivos de asistencia ventricular izquierda en el manejo del shock cardiogénico postinfarto agudo al miocardio
René Hameau D., Francesco Soriano, Jacopo A. Oreglia, Rodrigo Muñoz, José Luis Winter, Martín Valdebenito, Jorge Quitral, Dante Lindefjeld, Nicolás Veas
We report a 55-year-old woman with a history of hypothyroidism and type 2 diabetes mellitus who consulted at the emergency room because of intermittent oppressive chest discomfort. At admission, electrocardiogram showed a complete atrioventricular block. A transthoracic echocardiogram disclosed severe left ventricular dysfunction. The patient developed cardiogenic shock that required the installation of the Impella system. An emergency coronary angiography showed an ostial occlusion of the anterior descending artery. Despite successful primary angioplasty, she persisted with refractory shock and progressive hypoxemia. A concomitant connection to the extracorporeal membrane oxygenation system (ECMO) was decided. The support of both devices allowed the stabilization of the patient and the improvement of perfusion parameters.
