• Makiko Nakamura, Teruhiko Imamura, Akira Oshima, Mitsuo Sobajima, Shigeki Yokoyama, Toshio Doi, Kazuaki Fukahara, and Koichiro Kinugawa.
• The Second Department of Internal Medicine, University of Toyama, Toyama 930-0194, Japan.
• Medicina (Kaunas). 2022 May 25; 58 (6).

AbstractThe use of veno-arterial extracorporeal membrane oxygenation (ECMO) in patients with sepsis-induced cardiogenic shock has been reported, but the clinical implication of the Impella percutaneous axial-flow left ventricular assist device for such patients remains unknown. We had a 37-year-old man with septic shock and severely reduced cardiac function. Veno-arterial ECMO and concomitant Impella CP support ameliorated his end-organ dysfunction and achieved cardiac recovery, whereas severe mitral valve regurgitation due to chordal rupture developed later. Mitral valve replacement concomitant with ECMO removal as well as an Impella upgrade successfully treated the patient. ECMO and Impella support might be an effective therapeutic strategy for the bridge to recovery in patients with sepsis-induced cardiogenic shock; however, paying attention to mitral chordal rupture is highly encouraged.

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