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Krittanawong C, Rizwan A, Khawaja M, Newman N, Escobar J, Virk HUH, Alam M, Al-Azzam F, Yong CM, Jneid H. The Current State of Coronary Revascularization: Coronary Artery Bypass Graft Surgery Versus Percutaneous Coronary Interventions. Curr Cardiol Rep 2024:10.1007/s11886-024-02090-x. [PMID: 38985226 DOI: 10.1007/s11886-024-02090-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/28/2024] [Indexed: 07/11/2024]
Abstract
PURPOSE OF REVIEW The optimal revascularization strategy for coronary artery disease depends on various factors, such as disease complexity, patient characteristics, and preferences. Including a heart team in complex cases is crucial to ensure optimal outcomes. Decision-making between percutaneous coronary intervention and coronary artery bypass grafting must consider each patient's clinical profile and coronary anatomy. While current practice guidelines offer some insight into the optimal revascularization approach for the various phenotypes of coronary artery disease, the evidence to support either strategy continues to evolve and grow. Given the large amount of contemporary data on revascularization, this review aims to comprehensively summarize the literature on coronary artery bypass grafting and percutaneous coronary intervention in patients across the spectrum of coronary artery disease phenotypes. RECENT FINDINGS Contemporary evidence suggests that for patients with triple vessel disease, coronary artery bypass grafting is preferred over percutaneous coronary intervention due to better long-term outcomes, including lower rates of death, myocardial infarction, and target vessel revascularization. Similarly, for patients with left main coronary artery disease, both percutaneous coronary intervention and coronary artery bypass grafting can be considered, as they have shown similar efficacy in terms of major adverse cardiac events, but there may be a slightly higher risk of death with percutaneous coronary intervention. For proximal left anterior descending artery disease, both percutaneous coronary intervention and coronary artery bypass grafting are viable options, but coronary artery bypass grafting has shown lower rates of repeat revascularization and better relief from angina. The Synergy Between PCI with Taxus and Cardiac Surgery score can help in decision-making by predicting the risk of adverse events and guiding the choice between percutaneous coronary intervention and coronary artery bypass grafting. European and American guidelines both agree with including a heart team that can develop and lay out individualized, optimal treatment options with respect for patient preferences. The debate between coronary artery bypass grafting versus percutaneous coronary intervention in multiple different scenarios will continue to develop as technology and techniques improve for both procedures. Risk factors, pre, peri, and post-procedural complications involved in both revascularization strategies will continue to be mitigated to optimize outcomes for those patients for which coronary artery bypass grafting or percutaneous coronary intervention provide ultimate benefit. Methods to avoid unnecessary revascularization continue to develop as well as percutaneous technology that may allow patients to avoid surgical intervention when possible. With such changes, revascularization guidelines for specific patient populations may change in the coming years, which can serve as a limitation of this time-dated review.
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Affiliation(s)
| | - Affan Rizwan
- Department of Medicine, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Muzamil Khawaja
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Noah Newman
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Johao Escobar
- Division of Cardiology, Harlem Cardiology, NY, 10035, USA
| | - Hafeez Ul Hassan Virk
- Harrington Heart & Vascular Institute, Case Western Reserve University, University Hospitals, Cleveland Medical Center, Cleveland, USA
| | - Mahboob Alam
- Division of Cardiology, The Texas Heart Institute, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Fu'ad Al-Azzam
- Division of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Celina M Yong
- VA Palo Alto Medical Center, Department of Medicine, Stanford, University and Stanford Cardiovascular Institute, Palo AltoStanford, CACA, USA
| | - Hani Jneid
- Division of Cardiology, University of Texas Medical Branch, Houston, TX, 77030, USA
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Ivanov B, Krasivskyi I, Gerfer S, Sabashnikov A, Doss M, Holzhey D, Eghbalzadeh K, Rustenbach C, Kuhn E, Rahmanian PB, Mader N, Djordjevic I, Wahlers T. Impact of Initial Operative Urgency on Short-Term Outcomes in Patients Treated with ECMO Due to Postcardiotomy Cardiogenic Shock. Life (Basel) 2022; 12:life12111872. [PMID: 36431007 PMCID: PMC9696618 DOI: 10.3390/life12111872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022] Open
Abstract
The outcomes of patients with PCS and following ECMO therapy are associated with several preoperative risk factors. Our aim was to compare clinical presentation, ECMO-related data and in-hospital outcomes of patients treated with ECMO due to PCS after cardiac surgery, in regard to elective or emergent cardiac surgery procedures. Between April 2006 and October 2016, 164 consecutive patients that received VA-ECMO therapy due to PCS were identified and included in this retrospective cohort study. The patients were divided into groups based on the urgency of the initial procedures performed: elective group (ELG; n = 95) and an emergency group (EMG; n = 69). To compare the unequal patient groups, a propensity score-based matching (PSM) was applied (ELG, n = 56 vs. EMG, n = 56). The EMG primarily received ECMO intraoperatively (p ≤ 0.001). In contrast, the ELG were needed ECMO support more frequently postoperatively (p < 0.001). In-hospital mortality accounted for 71% (n = 40) in the ELG and 76% (n = 43) in the EMG (p = 0.518). Outcome data showed no major differences in the (abdominal ischemia (p = 0.371); septic shock (p = 0.393): rhythm disturbances (p = 0.575); emergency re-thoracotomy (p = 0.418)) between the groups. The urgency of the initial procedures performed is secondary in patients suffering PCS and following ECMO. In this regard, PCS itself seems to trigger outcomes in cardiac surgery ECMO patients substantially.
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Affiliation(s)
- Borko Ivanov
- Department of Cardiothoracic Surgery, Heart Centre, Helios Hospital Siegburg, 53721 Siegburg, Germany
| | - Ihor Krasivskyi
- Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, 50937 Cologne, Germany
- Correspondence: ; Tel.: +49-176-35388719
| | - Stephen Gerfer
- Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, 50937 Cologne, Germany
| | - Anton Sabashnikov
- Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, 50937 Cologne, Germany
| | - Mirko Doss
- Department of Cardiothoracic Surgery, Heart Centre, Helios Hospital Siegburg, 53721 Siegburg, Germany
| | - David Holzhey
- Department of Cardiothoracic Surgery, Helios University Hospital Wuppertal, University Witten/Herdecke, 42117 Wuppertal, Germany
| | - Kaveh Eghbalzadeh
- Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, 50937 Cologne, Germany
| | - Christian Rustenbach
- Department of Cardiothoracic Surgery, University Hospital Tuebingen, 72076 Tuebingen, Germany
| | - Elmar Kuhn
- Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, 50937 Cologne, Germany
| | | | - Navid Mader
- Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, 50937 Cologne, Germany
| | - Ilija Djordjevic
- Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, 50937 Cologne, Germany
| | - Thorsten Wahlers
- Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, 50937 Cologne, Germany
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Shin DG, Shin SD, Han D, Kang MK, Lee SH, Kim J, Cho JR, Kim K, Choi S, Lee N. Features of Patients Receiving Extracorporeal Membrane Oxygenation Relative to Cardiogenic Shock Onset: A Single-Centre Experience. MEDICINA-LITHUANIA 2021; 57:medicina57090886. [PMID: 34577809 PMCID: PMC8465743 DOI: 10.3390/medicina57090886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/20/2021] [Accepted: 08/24/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Extracorporeal membrane oxygenation (ECMO) can be helpful in patients with cardiogenic shock associated with myocardial infarction, and its early use can improve the patient survival rate. In this study, we report a mortality rate-difference analysis that examined the time and location of shock occurrence. Materials and Methods: We enrolled patients who underwent ECMO due to cardiogenic shock related to myocardial infarction and assigned them to either a pre- or post-admission shock group. The primary outcome was the 1-month mortality rate; a subgroup analysis was conducted to assess the effect of bailout ECMO. Results: Of the 113 patients enrolled, 67 (38 with pre-admission shock, 29 with post-admission shock) were analysed. Asystole was more frequently detected in the pre-admission shock group than in the post-admission group. In both groups, the commonest culprit lesion location was in the left anterior descending artery. Cardiopulmonary resuscitation was performed significantly more frequently and earlier in the pre-admission group. The 1-month mortality rate was significantly lower in the pre-admission group than in the post-admission group. Male sex and ECMO duration (≥6 days) were factors significantly related to the reduced mortality rate in the pre-admission group. In the subgroup analysis, the mortality rate was lower in patients receiving bailout ECMO than in those not receiving it; the difference was not statistically significant. Conclusions: ECMO application resulted in lower short-term mortality rate among patients with out-of-hospital cardiogenic shock onset than with in-hospital shock onset; early cardiopulmonary resuscitation and ECMO might be helpful in select patients.
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Affiliation(s)
- Dong-Geum Shin
- Department of Internal Medicine, Division of Cardiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Beodeunaru-ro 7-gil, Yeongdeungpo-gu, Seoul 07247, Korea; (D.-G.S.); (S.-D.S.); (M.-K.K.); (J.-R.C.); (S.C.); (N.L.)
| | - Sang-Deock Shin
- Department of Internal Medicine, Division of Cardiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Beodeunaru-ro 7-gil, Yeongdeungpo-gu, Seoul 07247, Korea; (D.-G.S.); (S.-D.S.); (M.-K.K.); (J.-R.C.); (S.C.); (N.L.)
| | - Donghoon Han
- Department of Internal Medicine, Division of Cardiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Beodeunaru-ro 7-gil, Yeongdeungpo-gu, Seoul 07247, Korea; (D.-G.S.); (S.-D.S.); (M.-K.K.); (J.-R.C.); (S.C.); (N.L.)
- Correspondence: or ; Tel.: +82-10-9956-5535; Fax: +82-2-2639-5359
| | - Min-Kyung Kang
- Department of Internal Medicine, Division of Cardiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Beodeunaru-ro 7-gil, Yeongdeungpo-gu, Seoul 07247, Korea; (D.-G.S.); (S.-D.S.); (M.-K.K.); (J.-R.C.); (S.C.); (N.L.)
| | - Seung-Hun Lee
- Department of Cardiothoracic Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07247, Korea; (S.-H.L.); (J.K.)
| | - Jihoon Kim
- Department of Cardiothoracic Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07247, Korea; (S.-H.L.); (J.K.)
| | - Jung-Rae Cho
- Department of Internal Medicine, Division of Cardiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Beodeunaru-ro 7-gil, Yeongdeungpo-gu, Seoul 07247, Korea; (D.-G.S.); (S.-D.S.); (M.-K.K.); (J.-R.C.); (S.C.); (N.L.)
| | - Kunil Kim
- Department of Cardiothoracic Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Suwon 14068, Korea;
| | - Seonghoon Choi
- Department of Internal Medicine, Division of Cardiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Beodeunaru-ro 7-gil, Yeongdeungpo-gu, Seoul 07247, Korea; (D.-G.S.); (S.-D.S.); (M.-K.K.); (J.-R.C.); (S.C.); (N.L.)
| | - Namho Lee
- Department of Internal Medicine, Division of Cardiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Beodeunaru-ro 7-gil, Yeongdeungpo-gu, Seoul 07247, Korea; (D.-G.S.); (S.-D.S.); (M.-K.K.); (J.-R.C.); (S.C.); (N.L.)
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Apruzzi L, Bossi M, Monaco F, Bertoglio L, Ajello S, Scandroglio M, Baccellieri D. Percutaneous Mechanical Thrombectomy of Atriocaval Floating Thrombus After Impella RP Removal in a Critically Ill Patient. J Cardiothorac Vasc Anesth 2020; 35:3743-3745. [PMID: 33342732 DOI: 10.1053/j.jvca.2020.11.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 11/11/2022]
Abstract
The rapid institution of mechanical circulatory support (MCS) during cardiogenic shock secondary to severe biventricular failure is strongly recommended. Despite the introduction of less-invasive devices and adequate anticoagulation protocols, the presence of vascular complications in patients treated with MCS has not yet been eliminated. Here, the authors report a 60-year-old patient treated with the Bi-Pella approach for biventricular failure. Despite anticoagulant therapy, the patient developed a floating thrombosis in the inferior vena cava extending to the right atrium after the Impella RP removal. Considering the thrombus instability and the risk of pulmonary embolism, the patient was treated urgently for a percutaneous mechanical thrombectomy using the AngioJet thrombectomy system. The procedure was completed without intraoperative complications, and both the completion angiography and transesophageal echocardiography showed complete thrombus removal. No procedure-related complications occurred, but the patient died from progressive worsening of left ventricular failure on the 16th postoperative day. In the case of proximal extensive deep vein thrombosis with an increased risk of pulmonary embolism, the use of percutaneous mechanical thrombectomy could be a therapeutic option, even in critically ill patients, due to its minimally invasive nature and low rates of complications.
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Affiliation(s)
- Luca Apruzzi
- Department of Vascular Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy.
| | - Matteo Bossi
- Department of Vascular Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Fabrizio Monaco
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Luca Bertoglio
- Department of Vascular Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Silvia Ajello
- Department of Cardiology, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Mara Scandroglio
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Domenico Baccellieri
- Department of Vascular Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
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Khera R, Secemsky EA, Wang Y, Desai NR, Krumholz HM, Maddox TM, Shunk KA, Virani SS, Bhatt DL, Curtis J, Yeh RW. Revascularization Practices and Outcomes in Patients With Multivessel Coronary Artery Disease Who Presented With Acute Myocardial Infarction and Cardiogenic Shock in the US, 2009-2018. JAMA Intern Med 2020; 180:1317-1327. [PMID: 32833024 PMCID: PMC9377424 DOI: 10.1001/jamainternmed.2020.3276] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 06/09/2020] [Indexed: 11/14/2022]
Abstract
Importance Cardiogenic shock after acute myocardial infarction (AMI) is associated with high mortality, particularly among patients with multivessel coronary artery disease. Recent evidence suggests that use of multivessel percutaneous coronary intervention (PCI) may be associated with harm. However, little is known about recent patterns of care and outcomes for this patient population. Objective To evaluate patterns in the use of multivessel PCI vs culprit-vessel PCI in AMI and cardiogenic shock and outcomes in the US from 2009 to 2018. Design, Setting, and Participants This cohort study identified all patients in the CathPCI Registry) with AMI and cardiogenic shock who had multivessel coronary artery disease and underwent PCI between July 1, 2009, and March 31, 2018. Exposures Multivessel or culprit-vessel PCI for AMI and shock. Primary Outcomes and Measures The primary outcome was in-hospital mortality. Temporal trends and hospital variation in PCI strategies were evaluated, while accounting for differences in case mix using hierarchical models. As a secondary outcome, the association of PCI strategy with postdischarge outcomes was evaluated in the subset of patients who were Medicare beneficiaries. Results Of 64 301 patients (mean [SD] age, 66.4 [12.5] years; 20 366 [31.7%] female; 54 538 [84.8%] White) with AMI and shock at 1649 US hospitals, 34.9% had primary multivessel PCI. In the subgroup of 48 943 patients with ST-segment elevation myocardial infarction (STEMI), 31.5% underwent multivessel PCI. Between 2009 and 2018, this percentage increased by 6.7% per year for AMI and 5.8% for STEMI. Overall, multivessel PCI was associated with a greater adjusted risk of in-hospital complications (odds ratio [OR], 1.18; 95% CI, 1.14-1.23) and with greater in-hospital mortality in patients with STEMI (OR, 1.11; 95% CI, 1.06-1.16). Among Medicare beneficiaries, multivessel PCI use was not associated with postdischarge 1-year mortality (51.5% vs 49.8%; risk-adjusted OR, 0.97; 95% CI, 0.90-1.04; P = .37). Significant hospital variation was found in the use of multivessel PCI, with a higher multivessel PCI rate for similar patients across hospitals (median OR, 1.37; 95% CI, 1.33-1.41). Patients at hospitals with high rates of PCI in STEMI use had higher risk-adjusted in-hospital mortality (highest vs lowest hospital multivessel PCI quartile: OR, 1.10; 95% CI, 1.02-1.19). Conclusions and Relevance This cohort study found that multivessel PCI was increasingly used as the revascularization strategy in AMI and shock and that hospitals that used multivessel PCI more, especially among patients with STEMI, had worse outcomes. With recent evidence suggesting harm with this strategy, there appears to be an urgent need to change practice and improve outcomes in this high-risk population.
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Affiliation(s)
- Rohan Khera
- Section of Cardiovascular Medicine, Department of
Internal Medicine, Yale School of Medicine, New Haven, Connecticut
- Center for Outcomes Research and Evaluation, Yale-New
Haven Hospital, New Haven, Connecticut
| | - Eric A. Secemsky
- Richard A. and Susan F. Smith Center for Outcomes
Research in Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Medicine, Harvard Medical School,
Boston, Massachusetts
| | - Yongfei Wang
- Section of Cardiovascular Medicine, Department of
Internal Medicine, Yale School of Medicine, New Haven, Connecticut
- Center for Outcomes Research and Evaluation, Yale-New
Haven Hospital, New Haven, Connecticut
| | - Nihar R. Desai
- Section of Cardiovascular Medicine, Department of
Internal Medicine, Yale School of Medicine, New Haven, Connecticut
- Center for Outcomes Research and Evaluation, Yale-New
Haven Hospital, New Haven, Connecticut
| | - Harlan M. Krumholz
- Section of Cardiovascular Medicine, Department of
Internal Medicine, Yale School of Medicine, New Haven, Connecticut
- Center for Outcomes Research and Evaluation, Yale-New
Haven Hospital, New Haven, Connecticut
| | - Thomas M. Maddox
- Division of Cardiology, Washington University School
of Medicine in St Louis, St Louis, Missouri
- Healthcare Innovation Lab, BJC HealthCare, Washington
University School of Medicine in St Louis, St Louis, Missouri
| | - Kendrick A. Shunk
- Veterans Affairs Medical Center, Division of
Cardiology, University of California, San Francisco
| | - Salim S. Virani
- Michael E. DeBakey Veterans Affairs Medical Center,
Division of Cardiology, Baylor College of Medicine, Houston, Texas
| | - Deepak L. Bhatt
- Department of Medicine, Harvard Medical School,
Boston, Massachusetts
- Division of Cardiology, Brigham and Women’s
Hospital, Boston, Massachusetts
| | - Jeptha Curtis
- Section of Cardiovascular Medicine, Department of
Internal Medicine, Yale School of Medicine, New Haven, Connecticut
- Center for Outcomes Research and Evaluation, Yale-New
Haven Hospital, New Haven, Connecticut
| | - Robert W. Yeh
- Richard A. and Susan F. Smith Center for Outcomes
Research in Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Medicine, Harvard Medical School,
Boston, Massachusetts
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Pan Y, Lu Z, Hang J, Ma S, Ma J, Wei M. Effects of Low-Dose Recombinant Human Brain Natriuretic Peptide on Anterior Myocardial Infarction Complicated by Cardiogenic Shock. Braz J Cardiovasc Surg 2017; 32:96-103. [PMID: 28492790 PMCID: PMC5409251 DOI: 10.21470/1678-9741-2016-0007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Accepted: 11/28/2016] [Indexed: 01/22/2023] Open
Abstract
Introduction The mortality due to cardiogenic shock complicating acute myocardial
infarction (AMI) is high even in patients with early revascularization.
Infusion of low dose recombinant human brain natriuretic peptide (rhBNP) at
the time of AMI is well tolerated and could improve cardiac function. Objective The objective of this study was to evaluate the hemodynamic effects of rhBNP
in AMI patients revascularized by emergency percutaneous coronary
intervention (PCI) who developed cardiogenic shock. Methods A total of 48 patients with acute ST segment elevation myocardial infarction
(STEMI) complicated by cardiogenic shock and whose hemodynamic status was
improved following emergency PCI were enrolled. Patients were randomly
assigned to rhBNP (n=25) and control (n=23) groups. In addition to standard
therapy, study group individuals received rhBNP by continuous infusion at
0.005 µg kg−1 min−1 for 72 hours. Results Baseline characteristics, medications, and peak of cardiac troponin I (cTnI)
were similar between both groups. rhBNP treatment resulted in consistently
improved pulmonary capillary wedge pressure (PCWP) compared to the control
group. Respectively, 7 and 9 patients died in experimental and control
groups. No drug-related serious adverse events occurred in either group. Conclusion When added to standard care in stable patients with cardiogenic shock
complicating anterior STEMI, low dose rhBNP improves PCWP and is well
tolerated.
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Affiliation(s)
- Yesheng Pan
- Heart Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, P.R. China
| | - ZhiGang Lu
- Heart Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, P.R. China
| | - Jingyu Hang
- Heart Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, P.R. China
| | - Shixin Ma
- Heart Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, P.R. China
| | - Jian Ma
- Heart Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, P.R. China
| | - Meng Wei
- Heart Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, P.R. China
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Santos V, Espinosa J, Lucerna A, Caravello A. An unusual case of renal calculi leading to myocardial infarction and cardiogenic shock. World J Emerg Med 2017; 8:148-150. [PMID: 28458761 DOI: 10.5847/wjem.j.1920-8642.2017.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Vanessa Santos
- Department of Emergency Medicine, Rowan University SOM Kennedy University Hospital, Stratford, NJ, USA
| | - James Espinosa
- Department of Emergency Medicine, Rowan University SOM Kennedy University Hospital, Stratford, NJ, USA
| | - Alan Lucerna
- Department of Emergency Medicine, Rowan University SOM Kennedy University Hospital, Stratford, NJ, USA
| | - Andrew Caravello
- Department of Emergency Medicine, Rowan University SOM Kennedy University Hospital, Stratford, NJ, USA
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