Successful use of left ventricular support device (Impella 5.0) and extracorporeal membrane oxygenation (ECMO) for postoperative cardiac arrest after lung cancer surgery: a case report

J Surg Case Rep. 2023 May 27;2023(5):rjad258. doi: 10.1093/jscr/rjad258. eCollection 2023 May.

Abstract

Postoperative hemodynamic support with an Impella 5.0 was effective in a man who underwent lung lobectomy for lung cancer and cardiogenic shock. A 75-year-old man presented to hospital with an abnormal chest shadow on radiography. After thorough examination, the patient was diagnosed with lung cancer, and left lower lobectomy was performed. On the 2nd postoperative day, the patient experienced cardiac arrest because of a sudden drop in saturation of percutaneous oxygen. After a third defibrillation, his heartbeat resumed, and he was intubated and placed on a ventilator. Coronary angiography revealed acute coronary syndrome and the patient fell into a state of shock, which required venoarterial extracorporeal membrane oxygenation (VA-ECMO) support. Nevertheless, the circulatory dynamics are unstable, and Impella 5.0 was introduced. VA-ECMO and the Impella 5.0 were discontinued on the 6th and 8th postoperative days, respectively. The patient was eventually transferred to a nearby facility for further rehabilitation 109 days later.

Keywords: ECMO; Impella; acute coronary syndrome; cardiac arrest; lung cancer.

Publication types

  • Case Reports