ESC, 2018 Mechanical circulatory support as bridge to urgent structural intervention

Patrick Horn, Malte Kelm, and Ralf Westenfeld


A 79-year-old woman was admitted in the emergency department as late comer in cardiogenic shock due to subacute nonST-elevation myocardial infarction, which clinically occurred 8 days prior. Coronary angiography depicted occlusion of a small circumflex artery. Revascularization was deemed unreasonable in the light of normal CK and elevated LDH/troponin serum levels. The patient was haemodynamically compromised with elevated lactate and imminent renal and liver failure. Acute Physiology and Chronic Health Evaluation (APACHE II) Score was 25 points corresponding to an in-hospital mortality of 51%. Percutaneous mechanical circulatory support (Impella CP) was implanted and haemodynamics stabilized over 48 h along with

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