-Case Reports-

Combined Therapy with Percutaneous Coronary Intervention and Percutaneous Aortic Valvuloplasty under Mechanical Support for an Elderly Patient with Cardiogenic Shock

Koji Kato¹, Naoki Sato¹, Nobuhiko Fujita¹, Takeshi Yamamoto¹, Yu-ki Iwasaki¹, Kenji Yodogawa¹, Morimasa Takayama², Keiji Tanaka¹ and Teruo Takano²

¹Intensive and Cardiac Care Unit, Department of Internal Medicine, Nippon Medical School
²Department of Internal Medicine, Nippon Medical School

Percutaneous aortic valvuloplasty is reportedly a useful tool for the management of critical and severe aortic stenosis with cardiogenic shock¹. However, early percutaneous coronary intervention for cardiogenic shock is beneficial for elderly patients with acute myocardial infarction^2,3. We describe a patient with critical aortic stenosis who presented with severe coronary stenosis of the left main trunk and the ostium of the right coronary artery. We performed percutaneous coronary intervention and percutaneous aortic valvuloplasty under intra-aortic balloon pump and percutaneous cardiopulmonary support. After these procedures, the cardiogenic shock was reversed, and the patient could be weaned from both intra-aortic balloon pump support and percutaneous cardiopulmonary support.

J Nippon Med Sch 2006; 73: 158-163

Keywords
cardiogenic shock, coronary intervention, aortic valvuloplasty, intra-aortic balloon pump, percutaneous cardiopulmonary support

Correspondence to
Koji Kato, Intensive and Cardiac Care Unit, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
katokoji@nms.ac.jp

Received, February 20, 2006
Accepted, March 28, 2006