Lots of interesting abstracts and cases were submitted for TCTAP 2022. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!

TCTAP C-072

Double Vessel Acute Myocardial Infarction With Extracorporeal Membrane Oxygenation(ECMO) Support

By Chin-Feng Tsai, Yao-Tsung Chuang

Go for JACC 0

Presenter

Yao-Tsung Chuang

Authors

Chin-Feng Tsai¹, Yao-Tsung Chuang¹

Affiliation

Chung Shan Medical University Hospital, Taiwan¹,

View Study Report

TCTAP C-072

CORONARY - Complex and Higher Risk Procedures for Indicated Patients (CHIP)

Double Vessel Acute Myocardial Infarction With Extracorporeal Membrane Oxygenation(ECMO) Support

Chin-Feng Tsai¹, Yao-Tsung Chuang¹

Chung Shan Medical University Hospital, Taiwan¹,

Clinical Information

Patient initials or Identifier Number

MR.Yang

Relevant Clinical History and Physical Exam

This 48-year-old man had Hypertension and hyperlipidemia. He smoked one pack per day for more than 30 years. He was brought to ER because of Chest pain with cold sweating and then syncope In the morning of admission day. When he arrived ER, He had cardiac collapse in ER; CPR was done.

ECMO support was done in ER. Then emergency PCI was arranged．

Relevant Test Results Prior to Catheterization

EKG revealed anterior wall STEMI and inferior wall STEMI; complete AV block was also noted.CXR revealed cardiomegaly and acute pulmonary edema.

Relevant Catheterization Findings

LM :patentLAD: middle LAD: 100% stenosis LCX: atherosclerosis change, distal LCXcollateral to distal RCARCA: proximal RCA: 100% stenosis

Interventional Management

Procedural Step

Strategy :Under ECMO support ,Left Trans-femoralapproach ; 8 Fr sheath PCI for RCA first because of D-LCXcollateral to RCA．JR4 SH guiding catheter (6 Fr)fielder fc Wire to D-RCA smoothly POBA for P-RCA (2.5x15 mm and 3.0x15mmballoons)Stenting(BMS) for RCA(D-RCA: 3.0x38mm and-RCA:3.5x23mm )PCI for LAD：EBU 3.5 SH guiding catheter (7 Fr)fielder fc Wire to D-LAD smoothly POBA for M-RCA (2.5x15 mm and 3.0x15mmballoons)Stenting(BMS) for M-LAD (3.0x23mm )

PCI for LAD.mov

PCI for RCA.mov

Case Summary

This patient survival after percutaneous coronary intervention(PCI), under extracorporeal membrane oxygenator (ECMO) and intra-aortic balloon pump (IABP) support; EKG revealed sinus rhythm； Mean　BP around 60-70 mmHg and consciousness alert about three days later; he can obey our order. We also prepared left ventricular assist device (LVAD) and heart transplantation for this patient. Unfortunately, patient expired 28 days later because of sepsis.
Conclusion:1. Complete AV block and acute anterior wall MI simultaneously exist in EKG is a critical sign2. ECMO support for Double vessel AMI is important and necessary3. Reperfusion as soon as possible can increased survival rate

Case

TCTAP C-072