Percutaneous cardiopulmonary support in refractory no-reflow with cardiogenic shock after coronary stenting in acute myocardial infarction

Yonsei Med J. 2010 Jul;51(4):599-601. doi: 10.3349/ymj.2010.51.4.599.

Abstract

Coronary no-reflow is defined as inadequate myocardial perfusion of a given coronary segment without angiographic evidence of mechanical vessel obstruction. No-reflow is visualized angiographically as a reduction in thrombolysis in myocardial infarction (TIMI) flow grade and is typically accompanied by chest pain, electrocardiographic changes with ST-segment shift and possible hemodynamic compromise. No-reflow during primary percutaneous coronary intervention (PCI) results in increasing mortality and morbidity. Therefore, treatment of noreflow is associated with improved clinical outcomes. Generally, the treatment of no-reflow is based on pharmacotherapy. In this case, despite maximal pharmacotherapy and intraaortic balloon pump (IABP), refractory no-reflow accompanied with cardiogenic shock was successfully treated with percutaneous cardiopulmonary support (PCPS).

Publication types

  • Case Reports

MeSH terms

  • Angioplasty, Balloon, Coronary / adverse effects*
  • Coronary Angiography
  • Female
  • Humans
  • Intra-Aortic Balloon Pumping
  • Middle Aged
  • Myocardial Infarction / therapy*
  • Shock, Cardiogenic / therapy*
  • Stents / adverse effects*