Copyright © 1993 by the European Society of Cardiology.
© 1993 The European Society of Cardiology
Primary cardiogenic shock during acute myocardial infarction: results of emergency cardiac transplantation
Hôpital Cardiovasculaire et Pneumologique Louis Pradel Lyon, France
Received 10 August 1992; revised 8 February 1993; .
Correspondence: P. Touboul, Hôpital Cardiovasculaire et Pneumologique Louis Pradel, BP Lyon-Montchat, 69394 Lyon Cédex 03, France
Abstract
Fifteen patients with acute myocardial infarction and cardiogenic shock underwent emergency cardiac transplantation after medical treatment failed to improve their haemodynamic status. Their mean age was 49 ± 7 years. The infarction was anterior in 12 cases, inferoposterior in two cases, and septal in one. Shock occurred within 3 days after the onset of chest pain in nine patients, and during the first day in six of them. Mechanical circulatory assistance was used in six patients as a bridge to transplantation when their haemodynamic status could not be stabilized pharmacologically. Orthotopic cardiac transplantation was performed an average of 15.6 ± 14 days after onset of infarction. Three patients died during the early post-operative period. Another died 7 months after transplantation. During the mean follow-up period of 30.6 ± 20.3 months, there were three acute rejections, all successfully treated, and one chronic rejection. The survival rate for this series is 70%. Thus, emergency cardiac transplantation may be the best option for selected patients with acute myocardial infarction and cardiogenic shock refractory to conventional therapy.
Key Words: Cardiac transplantation • cardiogenic shock • myocardial infarction
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