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Background Despite limited beneficial evidence, mechanical circulatory support (MCS) is commonly used in patients with acute myocardialinfarction-related cardiogenicshock (AMI-CS). In this Dutch registry, we investigated MCS usage, associated patient characteristics and clinical outcomes.
The patient in today’s case presented in cardiogenicshock from proximal LAD occlusion, in conjunction with a subtotally stenosed LMCA. Troponin T peaked at 38,398 ng/L ( = a very large myocardialinfarction, but not massive-- thanks to the pre-PCI spontaneous reperfusion, and rapid internvention!! ).
Admissions to CICUs with the highest tertile of CCRx utilization had a greater burden of comorbidities, had more diagnoses of ST–elevation myocardialinfarction, cardiac arrest, or cardiogenicshock, and had higher Sequential Organ Failure Assessment scores. CCRx was provided to 62.2% (interhospital range of 21.3%–87.1%)
LAD 80% mid LCx occluded mid (acute infarct lesion) RCA 80% mid. PCI mid LCx So this is an OMI (Occlusion MyocardialInfarction), but not a STEMI Echo: Decreased left ventricular systolic performance, mild/moderate. The patient went into cardiogenicshock and ultimately died of this MI. The cath lab was activated.
Many of these issues were described in a prior post by Dr. Angie Lobo ( @aloboMD ) (For open-access reviews of this literature, see Saw 2016 , Saw 2017 , or Hayes 2018.) were pretty sick, with mostly LM/pLAD lesions and high rates of cardiogenicshock. Lobo et al. examined SCAD presenting as STEMI (unlike Hassan et al.
Institutional Coronary Artery Bypass Case Volumes and Outcomes European Journal of Heart Failure October 2023 Makoto Mori Robotic Mitral Valve Repair for Degenerative Mitral Regurgitation The Annals of Thoracic Surgery August 2023 Carlos Diaz-Castrillion Volume-Failure to Rescue Relationship in Acute Type A Aortic Dissections: An Analysis of The Society (..)
Institutional Coronary Artery Bypass Case Volumes and Outcomes European Journal of Heart Failure October 2023 Makoto Mori 1 Robotic Mitral Valve Repair for Degenerative Mitral Regurgitation The Annals of Thoracic Surgery August 2023 Carlos Diaz-Castrillion 2 Volume-Failure to Rescue Relationship in Acute Type A Aortic Dissections: An Analysis of The (..)
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