Case Presentation: Lunch Symposium American Association for Thoracic - PowerPoint PPT Presentation

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Case Presentation: Lunch Symposium American Association for Thoracic Surgery . Mechanical Circulatory Support Symposium March 8, 2018. Houston, TX Presentation 43 healthy WF Found unresponsive by family Husband starts CPR EMS

Case Presentation: Lunch Symposium American Association for Thoracic Surgery . Mechanical Circulatory Support Symposium March 8, 2018. Houston, TX
Presentation •43 healthy WF •Found unresponsive by family •Husband starts CPR •EMS arrives – 27 minutes of CPR •Epi/Amio/Atropine/Magnesium •Intubated; aspiration •Arrives in ED
ED Arrival: 1030pm Saturday •Active CPR •What to do next ? •-- Stay with CPR go to Cath Lab •-- ECMO in ER •-- ECMO in Cath Lab •-- Futility/Comfort Measures
ED Arrival: 1030pm Saturday •What if she was 73 not 43? •What if CPR was ongoing for 50 mts? •What if it was asystole/PEA ?
Actually • ROSC achieved after 27 minutes just before ED arrival • No obvious ischemic ECG changes • PMH: MV Prolapse • FH: Mother died at 52 from SCD • Taken to cath lab
Presentation •LHC- Coronaries normal •Stunned LV on TT Echo •Monomorphic Runs of VT •What to do next? •-- Amio/Lido rebolus •-- Perc MCS (Impella, TandemHeart) •-- VA ECMO
Presentation •Impella placed •Deoxygenation •VA ECMO  17Fr L CFA and 21F R CFV
Presentation •Hypothermia Protocol? Yes/No •24 hrs Hypothermia to 34 degrees •Neurocritical Care Evaluation •Full Neuro recovery •ECMO & Impella decannulation after 60 hours •ICD, discharged HD 10, and plans for elective MV Repair
Case Presentation: Lunch Symposium American Association for Thoracic Surgery Mechanical Circulatory Support Symposium March 8, 2018. Houston, TX

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