ECMO against the background of endovascular intervention in a patient with acute coronary syndrome in conditions of resuscitation measures

Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) may be a critically important method for supporting patients with acute STsegment elevation coronary syndrome (STEMI) undergoing percutaneous coronary intervention (PCI) in high-risk settings.
Objective: to demonstrate the effectiveness of ECMO in a patient with severe cardiovascular insufficiency against the background of myocardial
ischemia in conditions of ongoing intensive care
Clinical observations: a case of the use of VA-ECMO before PCI in a 63-year-old patient with multiple occlusive stenotic lesions of the coronary bed is described. Due to the high risk of complications during planned PCI and ongoing CPR, it was decided to start VA-ECMO to provide mechanical circulatory support. Balloon angioplasty was performed with stenting of the LCA trunk and permanent residence with 2 stents in conditions of extracorporeal life support. After stenting, an effective sinus rhythm was independently restored. On the 4th day, decannulation and excommunication from ECMO were performed. On the 7th day, the patient was transferred from the ICU to the cardiology department. The patient was discharged on the 18th day.
Conclusion: the use of ECMO contributed to the stabilization of the patient’s vital signs in conditions of acute myocardial ischemia and made it possible to perform effective recanalization against the background of resuscitation measures.

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