Coronary interventions – Mini focus on out-of-hospital cardiac arrest and cardiogenic shock

Entrapment of the Impella heart pump in the mitral subvalvular apparatus

EuroIntervention 2021;16:e1262-e1263. DOI: 10.4244/EIJ-D-19-00942

Nauman Khalid
Nauman Khalid1, MD; Evan Shlofmitz1, DO; Brian C. Case1, MD; Ron Waksman1, MD
1. Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA

Figure 1. Impella entrapment in the mitral subvalvular apparatus in a patient with acute myocardial infarction and cardiogenic shock. A) - C) Coronary angiography. D) Cinefluoroscopy of the Impella in situ. E) TTE (parasternal long-axis view) - Impella abutting mitral valve (arrow). F) TEE showing flail P3 scallop (arrow). G) Colour TEE showing severe eccentric MR. H) 3D-TEE showing flail A3/P3 scallops. I) Ruptured chordae tendineae.

A 47-year-old man presented with witnessed out-of-hospital cardiac arrest at his wedding and anterior ST-elevation myocardial infarction. Initial blood pressure was 90/60 mmHg with pulse of 115 beats/minute. Coronary angiography showed 100% thrombotic ...

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Coronary interventionsInterventions for valvular diseaseSTEMIMitral valve replacement and repair
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