ABSTRACT
Patients in acute myocardial infarction (AMI) with serious complications such as malignant ventricular arrhythmia and cardiogenic shock couldn't receive emergency percutaneous coronary intervention (PCI) procedures and had high perioperative mortality. A case of AMI patients who suffered cardiac arrest and long-term cardiopulmonary resuscitation (CPR) was admitted to the department of critical care medicine of the First People's Hospital of Foshan. With the assistance of extracorporeal membrane oxygenation (ECMO), PCI and intra-aortic balloon counterpulsation (IABP) were performed. ECMO and ventilator were successfully weaned after anti-shock, mechanical ventilation, organ support treatment. The patient was successfully treated and discharged. After 6 months of follow-up, the patient recovered well in heart function.
ABSTRACT
Patients in acute myocardial infarction (AMI) with serious complications such as malignant ventricular arrhythmia and cardiogenic shock couldn't receive emergency percutaneous coronary intervention (PCI) procedures and had high perioperative mortality. A case of AMI patients who suffered cardiac arrest and long-term cardiopulmonary resuscitation (CPR) was admitted to the department of critical care medicine of the First People's Hospital of Foshan. With the assistance of extracorporeal membrane oxygenation (ECMO), PCI and intra-aortic balloon counterpulsation (IABP) were performed. ECMO and ventilator were successfully weaned after anti-shock, mechanical ventilation, organ support treatment. The patient was successfully treated and discharged. After 6 months of follow-up, the patient recovered well in heart function.
ABSTRACT
Patients in acute myocardial infarction (AMI) with serious complications such as malignant ventricular arrhythmia and cardiogenic shock couldn't receive emergency percutaneous coronary intervention (PCI) procedures and had high perioperative mortality. A case of AMI patients who suffered cardiac arrest and long-term cardiopulmonary resuscitation (CPR) was admitted to the department of critical care medicine of the First People's Hospital of Foshan. With the assistance of extracorporeal membrane oxygenation (ECMO), PCI and intra-aortic balloon counterpulsation (IABP) were performed. ECMO and ventilator were successfully weaned after anti-shock, mechanical ventilation, organ support treatment. The patient was successfully treated and discharged. After 6 months of follow-up, the patient recovered well in heart function.
ABSTRACT
Objective To evaluate the effects of intra-aortic balloon counterpulsation (IABP) on mortality of patients with acute myocardial infarction (AMI) treated with percutaneous coronary intervention (PCI).Methods Randomized controlled trials (RCTs) of IABP compared with non-IABP control in AMI patients, from January 1970 to May 2015, were searched from MEDLINE, Embase and Web of Science.The data were analyzed with software RevMan 5.0.Results Five RCTs involving 1 450 AMI patients, including 722 treated with IABP (IABP group) and 728 without IABP (non-IABP group), were included for analysis.Compared with non-IABP group, IABP did not significantly decrease the hospital mortality or 30-day mortality (OR=0.92, 95%CI: 0.69-1.25,P=0.61).According to the timing of IABP before or after PCI, it was further divided into IABP-before-PCI subgroup and IABP-after-PCI subgroup.Compared with non-IABP group, the 30-day mortality was not decreased in IABP-before-PCI subgroup or in IABP-after-PCI subgroup (OR=0.64, 95%CI: 0.23-1.78,P=0.39;OR=1.25, 95%CI: 0.42-3.77,P=0.69, respectively).According to complicating with cardiogenic shock (CS) or not, patients were divided to AMI with CS subgroup and AMI with no-CS subgroup;the hospital or 30-day mortality were not significantly decreased in both subgroups (OR=0.96, 95%CI: 0.70-1.32,P=0.80;OR=0.68, 95%CI: 0.28-1.70,P=0.27, respectively).Conclusion IABP does not decrease the 30-day mortality of AMI patients treated with PCI.
ABSTRACT
Objective To evaluate the outcome of patients with low ejection fraction undergoing coronary artery bypass grafting.Methods One hundred and twenty-eight consecutive patients with left ventricular ejection fraction (LVEF) ≤35％,who underwent Off-pump caronary bypass surgery or Cardiopulmonary coronary artery bypass between December 2000 and Novomber 2010 were studied.The outcome of early complication,mortality,LVEF were analyzed.Results LVEF and LVEDD were significantly increased in early postoperation (P ＜ 0.05 ).Use of Intra-aotric balloon counterpulsation(IABP) can decrease early mortality,and postopertive respiratory tract infections,renal insufficiency were found to be the main complications.Conclusions Preoperative low ejection fraction has no relationship with postoperative early mortality.using medicine to adjust heart function,strcity control blood pressure,blood glucose,heart rate preoperation,positive use of IABP postoperativon are key point to decrease early mortality.
ABSTRACT
An old male patient visited the hospital due to shortness of breath and palpitation for 6 h, with fever 3 days before and pump failure at admission. Having no risk factor of coronary diseases such as hypertension, diabetes mellitus and obesity, with ST-T changes and abnormal Q wave on ECC, the signs were compatible with those of acute anterior wall myocardial infarction, while the characteristics of cardiac biomarkers ( significant increase in Troponin I and creatine kinase's isoform, and normal creatine kinase) were not in accordance with those of acute myocardial infarction. Emergency angiography was performed, which indicated normal coronary artery, normal pulmonary artery and global systolic dysfunction of left ventricle. The diagnosis of acute severe myocarditis was established, and intra-aortic balloon pump (IABP) was employed to provide hemodynamic support. Severe myocarditis mimicking acute myocardial infarction may be fatal, and can be easily misdiagnosed. Careful analysis of clinical manifestations, early diagnostic angiography and possible IABP placement are important for the successful treatment.
ABSTRACT
Objective To evaluate the application of intra-aortic balloon counterpulsation(IABP) in acute myocardial infarction(AMI) with cardiogenic shock.Methods The study enrolled 65 AMI patients with cardiogenic shock and all the patients underwent primary PCI treatment.Among them,30 patients had IABP suppont during operations.Results In all the 30 cases with IABP support,the hemodynamic parameters improved in 30 minutes and stabilized in 2-8 hours.There was no reocclusion and death during querations.The death rate of the IABP group during hospitalization was 40%.Among the other 35 patients without IABP support,6 patients died during PCI and the in hospital death rate was 74.3%.Conclusion IABP can improve hemodynamic parameters and the perfusion of coronary artery in patients with cardiogenic shock.It can increase the success rate of primaty PCI,reduce the risk of low cardiac output and reocclusion during operation.IABP support during PCI can also improve the prognosis and reduce the motality rate of AMI patients with cardiogenic shock.