2021 年 27 巻 1 号 p. 33-36
Acute myocardial infarction (AMI) with cardiogenic shock (CS) has poor prognosis, despite using mechanical circulatory support devices. An 85-year-old woman with ST-elevation myocardial infarction (STEMI) was transferred to our hospital. STEMI was caused by plaque rupture of the left main trunk (LMT) along with CS and aborted myocardial damage. She suffered cardiopulmonary arrest despite intra-aortic balloon pumping (IABP) support. Veno-arterial extra corporeal membrane oxygenation (VA-ECMO) and Impella CP were immediately inserted to support the circulation and left ventricular unloading. Then she underwent percutaneous coronary intervention (PCI) and managed to survive. Transthoracic echocardiogram in the subacute phase revealed a preserved left ventricular systolic function though the culprit lesion was in LMT and the area at risk for myocardial infarction was extremely large. Left ventricular unloading using Impella CP could contribute to preservation of cardiac function and diminishing of myocardial damage.