158: Protected Transcatheter Aortic Valve Replacement with Perioperative Extracorporeal Membrane Oxygenation Support in Rescuing Catastrophic Cardiogenic Shock: A Case Report
Bibliographic record
Abstract
Perioperative complications of transcatheter aortic valve replacement (TAVR) are life-threatening. We report a successful case of TAVR with prophylactic pre-operative extracorporeal membrane oxygenation (ECMO) support for high-risk severe aortic valvular disease. A 76-year-old female, hospitalized for severe aortic stenosis and heart failure, developed ventricular tachycardia and severe cardiogenic shock on the eve of her scheduled TAVR procedure. The medical team promptly administered electrical cardioversion and CPR, but spontaneous circulation was not restored after 10 minutes of resuscitation. The ECMO team was called and arrived in 5 minutes, VA ECMO (Lifemotion®, Chinabridge) was successfully initiated in 22 minutes through percutaneously cannulated patient’s right femoral artery and vein under ultrasound guidance. The patient was then transferred to the intensive care unit for further treatment, her Glasgow Coma Scale score was 15 on the second day indicated a good recovery of neurological function. On the third day, under ECMO support, the patient successfully underwent the TAVR procedure. He was successfully weaned off ECMO on the seventh-day post-surgery with a raised ejection fraction of 43% and began rehabilitation exercises. After day 23rd, her heart function was classified as New York Heart Association Class II with an ejection fraction of 61%, and she was discharged with a significantly improved quality of life. Protected TAVR with perioperative ECMO support has become a new concept and strategy for treating high-risk patients. Patients’ cardiogenic shock and multi-organ conditions can be improved while on ECMO support, which provides safeguards and successful outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".