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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Published on: June 12, 2021

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Primary percutaneous coronary intervention for inferior ST-segment elevation myocardial infarction in a patient

Roberto Spina1, Maithri Siriwardena2, Nicole Bart3

  • 1Department of Interventional Cardiology, St Vincent's Hospital, Sydney, New South Wales, Australia.

Internal Medicine Journal
|September 12, 2017
PubMed

Insights

This case study details a patient with a HeartWare left ventricular assist device (LVAD) who experienced a heart attack and ventricular tachycardia. Successful percutaneous coronary intervention (PCI) resolved these critical issues, offering new insights for high-risk cardiac patients.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Mechanical Circulatory Support

Background:

  • A 63-year-old male with ischemic cardiomyopathy and a HeartWare left ventricular assist device (LVAD) presented with ventricular tachycardia and inferior ST-elevation myocardial infarction (STEMI).
  • The patient also exhibited acute right ventricular (RV) dysfunction secondary to the STEMI.

Observation:

  • The patient underwent primary percutaneous coronary intervention (PCI) with balloon angioplasty and stent placement in the right coronary artery.
  • Following PCI, the patient's ventricular arrhythmias resolved, RV systolic dysfunction improved, and RV size normalized.

Findings:

  • This is the first reported case of primary PCI in a patient with an established LVAD.
  • PCI in patients on full mechanical circulatory support is uncommon but feasible.

Implications:

  • This case highlights the potential for emergent revascularization in LVAD patients experiencing acute coronary syndrome.
  • It raises important clinical considerations for managing high-risk cardiac patients requiring mechanical support and emergent PCI.

Keywords:
HeartWareST-segment elevation myocardial infarctionleft ventricular assist deviceprimary percutaneous coronary intervention

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