Cor Vasa 2010, 52(4):265-269 | DOI: 10.33678/cor.2010.064

Mechanical cardiac support has been given the green light

Adrian Kolesár^1,*, Ján Luczy¹, Marta Jakubová², Martin Ledecký¹, Martin Studenčan³, Albert Hermely², Monika Jankajová³, František Sabol¹

¹ Klinika srdcovej chirurgie

² Oddelenie anesteziológie a intenzívnej medicíny

³ Klinika kardiológie, Východoslovenský ústav srdcových a cievnych chorôb, a. s., Košice, Slovenská republika

Mechanical cardiac support is currently one of the most dynamic areas of modern cardiology and cardiac surgery in the treatment of acute and chronic heart failure. The main objective is to improve or completely restore the corresponding hemodynamic parameters and adequate organ perfusion. In this paper, we present the tragic case of a female patient, in whom coronary angiography and quantification of two stenoses by intravascular ultrasound failed to predict an unfavourable clinical trend; three months later, the patient suffered an acute myocardial infarction due to critical stenosis of the left main coronary artery at a site originally described as "intact". Patient salvage was complicated by her unwillingness and emergency cardiac surgery revascularization was started with a two-hour delay, already in the presence of evolving cardiogenic shock. Comprehensive measures including successful revascularization, intra-aortic balloon contrapulsation and implantation of a biventricular assist device (Levitronix) failed to prevent the development of multiorgan failure, acute respiratory distress syndrome, and subsequent death of the patient. The interventional or surgical myocardial revascularizations are used in the presence of stenoses exceeding 50-60% of diameter. We believe, we will anticipate such cases from happening.

Keywords: Levitronix ventricular assist device; Acute myocardial infarction; Cardiogenic shock

Published: April 1, 2010  Show citation