Sujets)
Humains , Choc cardiogénique/rééducation et réadaptation , Dispositifs d'assistance circulatoire/classification , Transplantation cardiaque/rééducation et réadaptation , Cardiopathies/prévention et contrôle , Cardiopathies/thérapie , Échocardiographie/méthodes , Radiographie thoracique/méthodes , Agents cardiovasculaires/usage thérapeutique , Oxygénation extracorporelle sur oxygénateur à membrane/rééducation et réadaptation , Contrepulsion par ballon intra-aortique/méthodesRésumé
Cardiogenic shock after myocardial infarction has a high mortality even if early revascularization is achieved. Biventricular assist devices have not been used in Chile in this critical setting. We report a case of a 55 year-old diabetic man who suffered an acute chest pain and ventricular fibrillation. Prompt outside hospital defibrillation/ reanimation restored pulse and allowed emergency room transfer on mechanical ventilation. Electrocardiogram showed an anterior myocardial infarction and early revascularization was achieved by anterior descending artery angioplasty. However, severe cardiogenic shock continued in spite of inotropic and intra aortic balloon pump support. Levitronix Centrimag® biventricular mechanical circulatory support was inserted during reanimation for recurrent ventricular fibrillation and the patient listed for urgent cardiac transplantation upon stabilization. Heart transplantation was performed successfully 28 days later and the patient was discharged after a 21-day recovery period. Twelve months after transplant the patient is in NYHA functional class I with normal biventricular function. Levitronix Centrimag® biventricular mechanical circulatory support could be used successfully as a bridge-to-transplant for myocardial infarction cardiogenic shock.
Sujets)
Humains , Mâle , Adulte d'âge moyen , Transplantation cardiaque , Dispositifs d'assistance circulatoire/normes , Infarctus du myocarde/complications , Choc cardiogénique/rééducation et réadaptation , Choc cardiogénique/chirurgie , Facteurs tempsRésumé
O presente trabalho descreve o desenvolvimento de uma bomba centrífuga magnética, portátil de fácil instalação e baixo custo, que pode ser utilizada em pacientes que precisam de suporte ciculatório temporário e que foi empregada em 65 pacientes submetidos a cirurgia cardíaca