Kim Byung Gyu, Cho Sung Woo, Nah Jong Chun
Division of Cardiology, Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.
Acute Crit Care. 2020 Feb;35(1):46-50. doi: 10.4266/acc.2017.00024. Epub 2018 Nov 6.
The presentation of coronary artery disease in a patient with Eisenmenger syndrome (ES) is relatively rare. Cardiogenic shock due to coronary artery dissection during percutaneous coronary intervention (PCI) can be more critical in these patients. Here, we report a case of successful PCI under mechanical circulation support in a patient with ES who experienced potentially fatal right coronary artery dissection. This case emphasizes that use of extracorporeal membrane oxygenation (ECMO) can lead to successful management of critical complication during PCI, and that the immediate decision to apply of ECMO is important in ES patients who face impending cardiogenic shock with acute heart failure.
艾森曼格综合征(ES)患者出现冠状动脉疾病的情况相对少见。在这些患者中,经皮冠状动脉介入治疗(PCI)期间因冠状动脉夹层导致的心源性休克可能更为危急。在此,我们报告一例ES患者在机械循环支持下成功进行PCI的病例,该患者发生了可能致命的右冠状动脉夹层。本病例强调,体外膜肺氧合(ECMO)的使用可成功处理PCI期间的严重并发症,对于面临急性心力衰竭即将发生心源性休克的ES患者,立即决定应用ECMO至关重要。