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A fifty-one-year-old male with no significant medical history, presented with acute severe shortness of breath. Emergency echocardiogram revealed dilated cardiomyopathy and severe left ventricular dysfunction with an ejection fraction (EF) of 25–30%, and severe mitral regurgitation due to P2 cusp prolapse and ruptured chordae tendineae. Given the patients’ cardiogenic shock with severe refractory hypoxemia, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was implanted and inotrope support commenced. The patient underwent mitral valve repair and implantation of mechanical circulatory support Impella 5.0 pump (Abiomed, Danvers, MA, USA), for post-cardiotomy cardiogenic shock (PCCS). The Impella was explanted on the ninth postoperative day. The patient stayed in the intensive care unit for 11 days, including 3 days after explantation, and was discharged home 14 days post-explant and 23 days postoperatively with an EF of 35–40%.

annals of cardiothoracic surgery

Surgical technique for the implantation of mechanical circulatory support with the Impella 5.0 pump in a patient with post-cardiotomy cardiogenic shock