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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Aortic valve injury and complete atrioventricular block related to Impella device

Yu Inaba1, Yasunori Iida2, Yuki Kozai3

  • 1Department of Cardiovascular Surgery, Saiseikai Yokohamashi Tobu Hospital, 3-6-1 Shimosueyoshi, Yokohama, Kanagawa, 230-8765, Japan. yuys4223@gmail.com.

General Thoracic and Cardiovascular Surgery
|January 5, 2021
PubMed

Insights

This case report details a rare complication after Impella CP use for acute coronary syndrome: severe aortic regurgitation and heart block. Surgical aortic valve replacement successfully resolved these issues.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • High-risk percutaneous coronary intervention (PCI) and cardiogenic shock often require hemodynamic support.
  • The Impella device is utilized for left ventricular unloading in such critical scenarios.

Observation:

  • A 59-year-old man experienced severe acute aortic regurgitation and complete atrioventricular block (CAVB) with hemodynamic instability after Impella CP removal post-PCI for acute coronary syndrome.
  • A rare non-coronary cusp (NCC) tear was identified as the cause of the aortic regurgitation.

Findings:

  • The patient underwent successful aortic valve replacement.
  • Postoperatively, the patient showed no signs of CAVB, indicating successful management of the complication.

Implications:

  • This case highlights a rare but serious complication associated with Impella CP use.
  • Prompt diagnosis and surgical intervention, such as aortic valve replacement, are crucial for managing such adverse events.
  • Understanding potential complications is vital for optimizing patient care during high-risk cardiac procedures.

Keywords:
Aortic valve regurgitationImpella device

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