American Heart Association updated the guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care in November 2019. This focused update incorporates the systematic review conducted by the International Liaison Committee on Resuscitation, an expert group consisting of hundreds of international resuscitation scientists, to identify the new evidence supporting the basic and advanced life support and first aid in emergency medical care. This focused update involves the life chain of CPR (dispatcher-assisted CPR and cardiac arrest centers), advanced cardiovascular life support (advanced airways, vasopressors, and extracorporeal CPR), and first aid for presyncope. This present review aims to interpret these updates by reviewing the literature and comparing the recommendations in this update with previous guidelines.
A 69-year-old male was presented with exercise intolerance and progressive exertional dyspnea for 3 months. His main clinical diagnosis were degenerative valvular disease, severe aortic stenosis, severe aortic regurgitation, severe mitral regurgitation, severe tricuspid regurgitation, ventricular electrical storm, chronic heart failure, and New York Heart Association (NYHA) class Ⅳ heart function. He was encountered with sudden ventricular electrical storm in the emergency room. Extracorporeal membrane oxygenation (ECMO) was impanted beside during cardiopulmonary resuscitation. Emergency transcatheter aortic valve replacement (TAVR) was successfully performed under the guidance of transesophageal echocardiography when hemodynamics permitted. ECMO was withdrawn on the 5th day and discharged on the 21st day. TAVR is safe and effective for the treatment of high-risk aortic stenosis, and ECMO support is the key for the success of cardiopulmonary resuscitation.