PCI under ECMO support can be a feasible and life-saving strategy for patients with high-risk AMI complicated by cardiogenic shock and complex coronary anatomy.
May support ECMO-assisted PCI in select high-risk AMI shock cases; hypothesis-generating and requires prospective validation.
Acute myocardial infarction (AMI) complicated by cardiogenic shock is an uncommon, but fatal condition. It should be treated by early revascularization, including medication, percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG). Extracorporeal membrane oxygenation (ECMO) has been shown to lower the mortality rate associated with emergency PCI or CABG procedures in patients with unstable hemodynamics. We present a patient with coronary artery disease (CAD) consisting of triple vessel disease (TVD), a significant left main (LM) artery lesion, AMI and cardiogenic shock, who underwent PCI under ECMO support. There were no short-term or middle-term complications related to the PCI procedure; however, ECMO implantation led to a superficial wound infection. The patient was alive and well at six-month follow-up. We also review the literature regarding PCI under ECMO support for AMI complicated with cardiogenic shock patients.
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Lai et al. (2008) studied this question.
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