SLIDE 1
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
Case Presentation: Lunch Symposium American Association for Thoracic - - PowerPoint PPT Presentation
Case Presentation: Lunch Symposium American Association for Thoracic - - PowerPoint PPT Presentation
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
SLIDE 2
SLIDE 3
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
SLIDE 4
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 ?
SLIDE 5
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
SLIDE 6
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
SLIDE 7
Presentation
- Impella placed
- Deoxygenation
- VA ECMO 17Fr L CFA and 21F R CFV
SLIDE 8
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
SLIDE 9