Survival Following Cardiogenic Shock Caused by Acute Left Main Coronary Artery Total Occlusion

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Visceral ischemia and severe jaundice post-IABP implantation (n=1). Intervention: Intra-aortic balloon pump (IABP). Primary outcome: Resolution of hyperbilirubinemia and hepatic impairment following IABP removal.

Q: What does this research mean for the field?

Rescue percutaneous transluminal coronary angioplasty combined with intraaortic balloon pump support can achieve survival in cardiogenic shock caused by acute total occlusion of the left main coronary artery. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Tomonori Itoh; Kenichi Fukami; Seizou Oriso; Jun Umemura; Jun Nakajima; Hisato Obonai; Katsuhiko Hiramori; Kenichi Fukami

doi:10.1177/000331979704800210

February 1, 1997Angiology

Survival Following Cardiogenic Shock Caused by Acute Left Main Coronary Artery Total Occlusion

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Why the study?

Optimal sizing and positioning of intraaortic balloon pump (IABP) balloons to prevent visceral ischemia and related complications remain inadequately addressed.

Study Design

Type

Case Report (n=1)

Multicenter

No

PICO

P

Population

A 56-year-old female who developed severe progressive jaundice and visceral ischemia due to an aortic-balloon mismatch after receiving an intra-aortic balloon pump for postoperative low cardiac output syndrome.

I

Intervention / Comparator

Intra-aortic balloon pump (IABP) (Datascope Linear 34 French catheter (balloon diameter 15 mm, length 221 mm))

O

Primary Outcome

Resolution of hyperbilirubinemia and hepatic impairment following IABP removal

Limitations

Lack of preoperative aortic CT imaging to accurately size the IABP balloon, leading to an aortic-balloon mismatch.
Relying solely on patient height for IABP balloon sizing is inadequate and can increase the risk of visceral ischemia, particularly in petite individuals.

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Abstract

The authors describe a fifty-five-year-old Japanese man with an acute extensive anterior myocardial infarction associated with a total occlusion of the left main coronary artery. The patient suffered cardiogenic shock and was treated successfully with rescue percutaneous transluminal coronary angioplasty and an intraaortic balloon pump (IABP) after unsuccessful intracoronary thrombolysis. Ten days after admission, he was weaned from IABP, and recovery-phase coronary angiography revealed no significant coronary artery stenosis and an ejection fraction of 32% by left ventriculography. The patient was discharged from the hospital without any ischemic findings.

Discussion

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Cite This Study

Itoh et al. (1997) conducted a case report in Visceral ischemia and severe jaundice post-IABP implantation (n=1). Intra-aortic balloon pump (IABP) was evaluated on Resolution of hyperbilirubinemia and hepatic impairment following IABP removal.

synapsesocial.com/papers/6acae52763438f3c846c1b13 https://doi.org/10.1177/000331979704800210

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Survival Following Cardiogenic Shock Caused by Acute Left Main Coronary Artery Total Occlusion

Study Design

PICO

Limitations

Ask about this paper

Abstract

Discussion

Cite This Study

Survival Following Cardiogenic Shock Caused by Acute Left Main Coronary Artery Total Occlusion

Study Design

PICO

Limitations

Ask about this paper

Abstract

Discussion

Cite This Study

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