RESUMO
Acute mitral regurgitation (MR) secondary to papillary muscle rupture is a rare mechanical complication of acute myocardial infarction occurring in 0.05-0.26% of all cases of myocardial infarction. The only treatment is emergency mitral valve surgery with high operative mortality reaching up to 39%. The use of extracorporeal membrane oxygenator (ECMO) as a stabilization strategy and a bridge to recovery may potentially improve the outcome of such cases. Here, we report a case of acute MR presenting with cardiogenic shock and severe hypoxia that required insertion of veno-veno-arterial ECMO initially and followed by emergency mitral valve replacement. This strategy proved useful with full recovery of the patient.
RESUMO
BACKGROUND: Heart Failure is an epidemic with a current prevalence of over 5.8 million patients in the USA and almost 23 million patients worldwide, with high associated mortality risks. The severe shortage of donor organs for cardiac transplants and increasing number of heart failure patients has led to the increasing popularity of left ventricular assist device (LVAD) therapy for treatment of end-stage heart failure patients. This paper describes our initial clinical experience with LVAD therapy of heart failure patients at our clinic. METHODS: Ten patients (eight males and two females) with a mean age of 48 years (range, 14-68 years) were implanted with LVADs as bridge to transplantation (BT) or destination therapy (DT) at our clinic between January 2015 and October 2017. RESULTS: Preliminary results were very promising with 0% 30-day mortality rates and no major surgical complications or LVAD thrombosis. CONCLUSIONS: Such results of LVAD implantation in Kuwait indicate the feasibility of establishing De Novo LVAD programs in low volume LVAD centers (≤10 implants/year) with promising results and offer a new era of hope for treating advanced heart failure patients.
