Venoarterial Extracorporeal Membrane Oxygenation for “Protected” Percutaneous Coronary Intervention Secondary to Refractory Polymorphic Ventricular Tachycardia and Cardiac Arrest

Abstract

We present a case of cardiogenic shock secondary to refractory polymorphic ventricular tachycardia associated with coronary ischemia resulting in cardiac arrest. Following the return of spontaneous circulation, the patient was cannulated for peripheral venoarterial extracorporeal membrane oxygenation (V-A ECMO) in anticipation of high-risk “protected” percutaneous coronary intervention (PCI). Under full V-A ECMO support, inotropes and vasopressors were weaned off, and the patient underwent uneventful PCI of left circumflex and obtuse marginal lesions. After 48 hours, the patient was decannulated and could be discharged home alive 16 days after his initial cardiac arrest.

Keywords

• extracorporeal cardiopulmonary resuscitation (ecpr)
• extracorporeal life support (ecls)
• mechanical circulatory support (mcs)
• protected percutaneous coronary intervention (pci)
• refractory polymorphic ventricular tachycardia (pvt)
• venoarterial extracorporeal membrane oxygenation (v-a ecmo)