PMID- 37575534
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230815
IS  - 2514-2119 (Electronic)
IS  - 2514-2119 (Linking)
VI  - 7
IP  - 8
DP  - 2023 Aug
TI  - Haemodynamic effects of inhaled nitric oxide in acute myocardial infarction 
      complicated by right heart failure under ECPELLA support: case report.
PG  - ytad369
LID - 10.1093/ehjcr/ytad369 [doi]
LID - ytad369
AB  - BACKGROUND: Recently, mechanical support obtained with the combination of 
      venoarterial extracorporeal membrane oxygenation (VA-ECMO) and an Impella device, 
      together referred to as ECPELLA, has been shown to be effective for acute 
      myocardial infarction with cardiogenic shock. However, methods for withdrawing 
      VA-ECMO in acute myocardial infarction cases complicated by right ventricular 
      dysfunction are yet to be established. Here, we report the effective use of 
      inhaled nitric oxide during the weaning of VA-ECMO from the ECPELLA management of 
      a patient with acute myocardial infarction with cardiogenic shock. CASE SUMMARY: 
      An 81-year-old man with an acute extensive anterior wall myocardial infarction 
      with cardiogenic shock was supported with ECPELLA to improve his haemodynamics. 
      During ECPELLA, the Impella device could not maintain sufficient flow. 
      Echocardiography revealed a small left ventricle and an enlarged right ventricle, 
      indicating acute right heart failure. Inhaled nitric oxide was initiated to 
      reduce right ventricle afterload, which decreased pulmonary artery pressure from 
      34/20 to 27/13 mmHg, improved right and left ventricle sizes, and stabilized the 
      Impella support. Afterward, VA-ECMO could be withdrawn because the Impella alone 
      was sufficient for haemodynamic support. DISCUSSION: Inhaled nitric oxide 
      improved right ventricle performance in a patient with severe myocardial 
      infarction with right heart failure supported by ECPELLA. Thus, we suggest that 
      inhaled nitric oxide facilitates the weaning of VA-ECMO from patients with 
      refractory right ventricular dysfunction who are supported by ECPELLA.
CI  - (c) The Author(s) 2023. Published by Oxford University Press on behalf of the 
      European Society of Cardiology.
FAU - Fujita, Kosuke
AU  - Fujita K
AUID- ORCID: 0000-0003-2001-1543
AD  - Department of Cardiology, Kindai University Hospital, 377-2 Onohigashi 
      Osakasayamashi, 589-8511 Osaka, Japan.
FAU - Ueno, Masafumi
AU  - Ueno M
AD  - Department of Cardiology, Kindai University Hospital, 377-2 Onohigashi 
      Osakasayamashi, 589-8511 Osaka, Japan.
FAU - Yasuda, Masakazu
AU  - Yasuda M
AD  - Department of Cardiology, Kindai University Hospital, 377-2 Onohigashi 
      Osakasayamashi, 589-8511 Osaka, Japan.
FAU - Mizutani, Kazuki
AU  - Mizutani K
AD  - Department of Cardiology, Kindai University Hospital, 377-2 Onohigashi 
      Osakasayamashi, 589-8511 Osaka, Japan.
FAU - Miyoshi, Tatsuya
AU  - Miyoshi T
AD  - Department of Cardiology, Kindai University Hospital, 377-2 Onohigashi 
      Osakasayamashi, 589-8511 Osaka, Japan.
FAU - Nakazawa, Gaku
AU  - Nakazawa G
AUID- ORCID: 0000-0002-6721-1342
AD  - Department of Cardiology, Kindai University Hospital, 377-2 Onohigashi 
      Osakasayamashi, 589-8511 Osaka, Japan.
LA  - eng
PT  - Case Reports
DEP - 20230802
PL  - England
TA  - Eur Heart J Case Rep
JT  - European heart journal. Case reports
JID - 101730741
PMC - PMC10422691
OTO - NOTNLM
OT  - Acute myocardial infarction
OT  - Case report
OT  - ECPELLA
OT  - Impella
OT  - Inhaled nitric oxide
OT  - VA-ECMO
COIS- Conflict of interest: None declared.
EDAT- 2023/08/14 06:43
MHDA- 2023/08/14 06:44
PMCR- 2023/08/02
CRDT- 2023/08/14 04:31
PHST- 2022/12/07 00:00 [received]
PHST- 2023/07/12 00:00 [revised]
PHST- 2023/07/31 00:00 [accepted]
PHST- 2023/08/14 06:44 [medline]
PHST- 2023/08/14 06:43 [pubmed]
PHST- 2023/08/14 04:31 [entrez]
PHST- 2023/08/02 00:00 [pmc-release]
AID - ytad369 [pii]
AID - 10.1093/ehjcr/ytad369 [doi]
PST - epublish
SO  - Eur Heart J Case Rep. 2023 Aug 2;7(8):ytad369. doi: 10.1093/ehjcr/ytad369. 
      eCollection 2023 Aug.