Percutaneous coronary intervention under temporary peripheral veno-arterial extracorporeal membrane oxygenation

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiovascular Surgery

Background:

• Subacute ST-elevation myocardial infarction (STEMI) presents a significant challenge, particularly with severely depressed left ventricular ejection fraction.
• Severe three-vessel coronary artery disease (CAD) necessitates complex revascularization strategies.

Observation:

• A 68-year-old female patient presented with STEMI and a left ventricular ejection fraction of 15%.
• The patient was hemodynamically stable despite the critical cardiac condition.

Findings:

• Percutaneous coronary intervention (PCI) was successfully performed.
• Peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provided effective hemodynamic support during PCI.
• The combined approach was performed without complications.

Implications:

• This case highlights the feasibility and safety of VA-ECMO-assisted PCI in high-risk STEMI patients with severe CAD and LV dysfunction.
• Heart team collaboration is crucial for optimizing treatment strategies in complex cardiovascular cases.
• VA-ECMO can be a valuable tool for stabilizing patients undergoing complex interventions for acute myocardial infarction.