Key result
VA-ECMO rapidly restores haemodynamics and resolves post-cardiac arrest LVOT obstruction and systolic anterior motion.
Why the study?
Severe dynamic left ventricular outflow tract obstruction (LVOTO) with systolic anterior motion (SAM) can cause critical haemodynamic compromise after cardiac arrest, and optimal management strategies are not well established.
Case Report (n=1)
No
BACKGROUND: Obstruction of the left ventricular outflow tract (LVOT) as seen in hypertrophic cardiomyopathy is a dynamic condition with a wide range of clinical presentations and symptoms. CASE SUMMARY: We report the use of veno-arterial extracorporeal membrane oxygenation in a female patient who was resuscitated after out-of-hospital cardiac arrest. Soon after admission the patient developed critical haemodynamic compromise due to severe obstruction of the left ventricle outflow tract and systolic anterior motion (SAM) of the mitral valve. Veno-arterial extracorporeal membrane oxygenation restored haemodynamics and was weaned after 4 days without any haemodynamic compromise due to SAM. The patient was discharged from the intensive care unit at Day 13, and after 3 days at the coronary care unit, she was discharged to ambulatory follow-up with no sequelae. DISCUSSION: Veno-arterial extracorporeal membrane oxygenation restored haemodynamic stability in this patient with dynamic severe LVOT obstruction following cardiac arrest.
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Oxlund et al. (2018) conducted a case report in Cardiogenic shock and haemodynamic instability due to severe dynamic left ventricular outflow tract obstruction and systolic anterior motion following cardiac arrest (n=1). Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was evaluated on Restoration of haemodynamics and resolution of left ventricular outflow tract obstruction and systolic anterior motion. Veno-arterial extracorporeal membrane oxygenation rapidly restored haemodynamic stability and resolved systolic anterior motion and left ventricular outflow tract obstruction following cardiac arrest.
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