Coronary artery bypass grafting and mechanical circulatory support in penetrating cardiac injury: a clinical case
https://doi.org/10.33667/2078-5631-2025-35-7-10
Abstract
Objective. To describe a clinical case of venoarterial extracorporeal membrane oxygenation (VA-ECMO) used in a patient with a combination of penetrating cardiac injury, myocardial infarction, and emergency coronary artery bypass grafting (CABG).
Materials and methods. A 37-year-old male patient with a stab wound to the anterior chest wall complicated by hemopericardium, cardiogenic shock, and acute myocardial infarction is presented. Due to persistent systemic hemodynamic instability following initial surgical intervention, peripheral VA-ECMO was initiated, followed by emergency CABG.
Results. The use of VA-ECMO allowed hemodynamic stabilization and created optimal conditions for subsequent bypass surgery without aortic crossclamping. After 72 hours of support, positive dynamics were achieved, with recovery of left ventricular ejection fraction to 52% by the time of discharge.
Conclusion. This case demonstrates the potential effectiveness of VA-ECMO as a component of complex therapy in patients with combined cardiac injury. A multidisciplinary approach played a key role in achieving a favorable outcome.
About the Authors
N. S. Chibisov
Botkin Hospital
Russian Federation
Russian Federation
Chibisov Nikita S., anesthesiologist and Intensive Care specialist
A. V. Vlasenko
Botkin Hospital
Russian Federation
Russian Federation
Vlasenko Alexey V., head of Anesthesiology and Intensive Care Dept No. 32
I. A. Glushenko
Botkin Hospital
Russian Federation
Russian Federation
Glushenko Igor A., head of Cardiac Surgery Dept No. 40
P. A. Zhezhuk
Botkin Hospital
Russian Federation
Russian Federation
Zhezhuk Pavel A., anesthesiologist and Intensive Care specialist
D. I. Levikov
Botkin Hospital
Russian Federation
Russian Federation
Levikov Dmitry I., head of Anesthesiology and Intensive Care Dept No. 52
A. G. Komarova
Botkin Hospital
Russian Federation
Russian Federation
Komarova Anna G., deputy chief physician for the Regional Vascular Center
E. P. Rodionov
Botkin Hospital
Russian Federation
Russian Federation
Rodionov Evgeny P., deputy chief physician for Anesthesiology and Intensive Care
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Review
For citations:
Chibisov N.S., Vlasenko A.V., Glushenko I.A., Zhezhuk P.A., Levikov D.I., Komarova A.G., Rodionov E.P. Coronary artery bypass grafting and mechanical circulatory support in penetrating cardiac injury: a clinical case. Medical alphabet. 2025;(35):7-10. (In Russ.) https://doi.org/10.33667/2078-5631-2025-35-7-10
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