tailieunhanh - Báo cáo y học: "Treatment of cardiogenic shock with left ventricular assist device combined with cardiac resynchronization therapy: A case report"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Treatment of cardiogenic shock with left ventricular assist device combined with cardiac resynchronization therapy: A case report. | Keilegavlen et al. Journal of Cardiothoracic Surgery 2010 5 54 http content 5 1 54 Jdfrs JOURNAL OF CARDIOTHORACIC SURGERY CASE REPORT Open Access Treatment of cardiogenic shock with left ventricular assist device combined with cardiac resynchronization therapy A case report Hâvard Keilegavlen Jan Erik Nordrehaug Svein Faerestrand Rune Fanebust Reidar Rettersen Rune Haaverstad and Vegard Tuseth Abstract Cardiogenic shock has a poor prognosis with established treatment strategies. We report a 62 years old man with heart failure exacerbating into refractory cardiogenic shock successfully treated with the combination of a percutaneous left ventricular assist device LVAD and subacute cardiac resynchronization therapy CRT implantable cardioverterdefibrillator device CRT-D . Background The mortality rate in patients with cardiogenic shock is still very high 1 . Medical therapy has symptomatic effects but has no proven reduction of mortality. Percu-taneously placed LVAD is an option for selected groups of these patients. The percutaneous microaxial blood pump Impella LP Abiomed Aachen Germany can be rapidly deployed with low complication rates and have improved hemodynamic effects compared with the intraaortic balloon pump IABP 2-4 . Furthermore in selected patients with stable heart failure CRT is proven to relive symptoms and improve outcomes 5 . The potential efficiency of acute and subacute CRT treatment in patients with cardiogenic shock has to our knowledge not been studied. Case presentation A previously healthy 62 years old man who had experienced reduced exercise capacity for the last 6 months was admitted to the local hospital after 2 weeks of increasing dyspnoea. Echocardiography revealed biventricular dilatation reduced wall thickness asynchronous left ventricular LV contraction and left ventricular ejection fraction LVEF of 10 . ECG showed left bundle branch block QRS width 170 msec . The clinical condition deteriorated .