Extracorporeal membrane oxygenation as bridge to recovery in infarction-related refractory right heart failure [Extrakorporale Membranoxygenierung als 'bridge-to-recovery' bei infarktbedingtem therapierefrakt?rem Rechtsherzversagen]

摘要

History and clinical findings: We present a 41-year-old man with cardiac arrest in need of cardiopulmonary resuscitation (CPR) with the diagnosis of a posterior wall infarction, who was hospitalized in our cardiac centre. Investigations: The cardiac catheterization showed a thrombotic obstruction of the right coronary artery. After percutaneous coronary revascularization a hemodynamically stable situation could be achieved and the patient was admitted to the intensive care unit (ICU). Treatment and clinical course: The patient became again hemodynamically unstable and a CPR was required. Based on the acute right heart failure with therapy refractory cardiogenic shock we decided within our heart team for an extra corporeal membrane oxygenation (ECMO) applied during CPR in the ICU. The extracorporeal support was needed for three days. Seven days after the emergency cardiac catheterization the patient was extubated and transferred to our intermediate care. Conclusion: Extracorporeal life support is feasible und effective for bridging therapy in patients with acute ischemic right heart failure with refractory cardiogenic shock and successful reperfusion therapy.