Awake extracorporeal membrane oxygenation (ECMO) as bridge to recovery after left main coronary artery occlusion: a promising concept of haemodynamic support in cardiogenic shock

Abstract

Cardiogenic shock following acute myocardial infarction is associated with high mortality rate. Different management concepts including fluid management, inotropic support, intra aortic balloon counterpulsation (IABP) and extracorporeal membrane oxygenation (ECMO) mainly in mechanically ventilated patients have been used as cornerstones of management. However, success rates have been disappointing. Few reports suggested that ECMO when performed under circumvention of mechanical ventilation, may offer some survival benefits. We herein present our experience with the use of veno-arterial ECMO as bridge to recovery in an awake and spontaneously breathing patient after left main coronary artery occlusion complicated by cardiogenic shock.

Keywords: Acute myocardial infarction; Cardiogenic shock; Extracorporeal membrane oxygenation (ECMO).