Improvement of persistent anuria in severe myocardial infarction: the potential role of Impella 5.5 as a bridge to decision.
BMJ Case Rep
; 16(12)2023 Dec 21.
Article
em En
| MEDLINE
| ID: mdl-38129092
ABSTRACT
A man in his 40s with ST-segment elevation myocardial infarction complicating cardiogenic shock was transferred to our hospital. Emergent percutaneous coronary intervention for the left anterior descending and left circumflex arteries supported with Impella CP was performed. However, his cardiac function was severely impaired, and anuria developed, necessitating continuous renal replacement therapy (CRRT). After Impella CP was removed on day 6, the patient remained dependent on inotropes and CRRT. Following volume reduction to manage pulmonary congestion, symptoms of low perfusion appeared. Then, Impella 5.5 was inserted on day 38 as a bridge to decision. On day 52, the urine volume reached >2000 mL/day, and CRRT was discontinued. On day 56, the patient was transferred to a certified facility for left ventricular assist device implantation or heart transplantation. This case suggests the potential of Impella 5.5 as a bridge to decision in patients with organ failure caused by low cardiac output.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Anuria
/
Coração Auxiliar
/
Infarto do Miocárdio
Limite:
Humans
/
Male
Idioma:
En
Revista:
BMJ Case Rep
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Japão
País de publicação:
Reino Unido