Heart, lung & circulation
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Heart, lung & circulation · Oct 2014
Review Meta Analysis Comparative StudyCoronary artery bypass grafting versus combined coronary artery bypass grafting and mitral valve repair in treating ischaemic mitral regurgitation: a meta-analysis.
Ischaemic mitral regurgitation (IMR) is commonly manifested after coronary artery disease, but it is still controversial as to whether coronary artery bypass grafting (CABG) alone improves postoperative outcome. ⋯ Compared with CABG alone, patients who underwent combined CABG and MVR procedures showed a greater improvement in postoperative MR grade, but in terms of in-hospital mortality, MR grade improvement rate, postoperative mean NYHA functional class and five-year survival, adding MVR to CABG surgery lacks evidence to show its superiority.
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Heart, lung & circulation · Oct 2014
Case ReportsAwake extracorporeal membrane oxygenation (ECMO) as bridge to recovery after left main coronary artery occlusion: a promising concept of haemodynamic support in cardiogenic shock.
Cardiogenic shock following acute myocardial infarction is associated with high mortality rate. Different management concepts including fluid management, inotropic support, intra aortic balloon counterpulsation (IABP) and extracorporeal membrane oxygenation (ECMO) mainly in mechanically ventilated patients have been used as cornerstones of management. ⋯ Few reports suggested that ECMO when performed under circumvention of mechanical ventilation, may offer some survival benefits. We herein present our experience with the use of veno-arterial ECMO as bridge to recovery in an awake and spontaneously breathing patient after left main coronary artery occlusion complicated by cardiogenic shock.
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Heart, lung & circulation · Oct 2014
Extracorporeal membrane oxygenation for very high-risk transcatheter aortic valve implantation.
Transcatheter aortic valve implantation (TAVI) can cause profound haemodynamic perturbation in the peri-operative period. Veno-arterial extracorporeal membrane oxygenation (ECMO) can be used to provide cardiorespiratory support during this time, either prophylactically or emergently. ⋯ Instituting prophylactic ECMO in selected very high-risk patients may help avoid consequences of intra-operative complications and the need for emergent rescue ECMO.