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Updated: Oct 7, 2026

Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
07:39

Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock

Published on: August 16, 2021

[Cardiogenic shock complicating extensive infarction with ventricular septal defect. Circulatory assistance and heart

E Tatou1, M C Gomez, P Leneuf

  • 1Service de chirurgie cardiovasculaire (Pr M. David), hôpital du Bocage, CHU Dijon, BP 1542, bd de Lattre-de-Tassigny, 21034 Dijon.

Archives Des Maladies Du Coeur Et Des Vaisseaux
|May 8, 2001
PubMed

Insights

This case highlights a patient with myocardial infarction and cardiogenic shock who developed a ventricular septal defect. Mechanical circulatory support was initiated, followed by successful cardiac transplantation.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery

Background:

  • Massive anterior myocardial infarction leading to cardiogenic shock.
  • Development of a ventricular septal defect (VSD) with significant left-to-right shunt.
  • Initial management included angioplasty, intra-aortic balloon pumping, and inotropic support.

Observation:

  • Biventricular assist device (MEDOS) implantation was performed due to persistent hemodynamic instability.
  • Transesophageal echocardiography revealed progressive VSD shunt increase, device flow decrease, and thrombus formation.
  • Complications included cardiac tamponade, necessitating drainage, and valve blockage requiring anticoagulation adjustment.

Findings:

  • The patient's condition stabilized after managing complications and before cardiac transplantation.
  • Successful orthotopic heart transplantation was performed on the 8th day.
  • The case underscores the complexities of managing VSD post-myocardial infarction with mechanical circulatory support.

Implications:

  • Challenges in the daily monitoring and management of cardiac assist devices.
  • Cardiac transplantation as a viable option for patients with VSD and cardiogenic shock refractory to mechanical support.
  • Importance of vigilant surveillance for device-related complications and timely intervention.

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