Impella-Clip: a secure and effective strategy in cardiogenic shock due to acute severe mitral regurgitation

Impella-Clip: a secure and effective strategy in cardiogenic shock due to acute severe mitral regurgitation

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CASE PRESENTATION This is the case of a 61-year-old man with cardiovascular risk factors who presents with a 3-day history of intermittent oppressive pain in the middle of his chest.The electrocardiogram confirmed the presence of an inferior-posterior wall ST-segment elevation.The emergency coronary angiography revealed the acute occlusion of a dominant left circumflex artery (videos 1 and 2 of the supplementary data) exm1996 that was revascularized with 2 drug-eluting stents in the proximal left circumflex artery (bifurcation with the first obtuse marginal artery) using the TAP technique (T and small protrusion) (figure 1 and video 3 of the supplementary data).No other significant epicardial lesions were found.

During the procedure the patient became desaturated, developed progressive hypotension, and eventually required dodge charger carbon fiber spoiler invasive mechanical ventilation and intra-aortic balloon pump implantation.The echocardiogram confirmed the presence of significant mitral regurgitation (MR) with a slightly depressed left ventricular ejection fraction (LVEF) and inferior-lateral and apical akinesis with preserved right ventricular function.The transesophageal echocardiography confirmed the diagnosis of acute mitral regurgitation of ischemic etiology with a predominant jet at medial level, and no organ damage to the valve or the subvalvular apparatus (figure 2 and video 4 of the supplementary data).Within the next few.