Suárez de Lezo José, Pan Manuel, Medina Alfonso, Pavlovic Djordje, Romero Miguel, Segura José, Ruiz Martin, Ojeda Soledad, Muñoz Juan, Rodriguez Marcos
Servicio de Cardiología, Hospital Reina Sofía, University of Córdoba, Córdoba, Spain.
Catheter Cardiovasc Interv. 2002 Dec;57(4):467-75. doi: 10.1002/ccd.10340.
Percutaneous cardiopulmonary support (CPS) has proven to be a technique of value in high-risk coronary patients undergoing percutaneous balloon angioplasty. Since May 1994, we have combined the use of CPS and coronary stent revascularization in 92 patients. In 68 of them, the CPS was used as a prophylactic procedure (group 1); in the remaining 24, the CPS was used as an emergency procedure to stabilize and even resuscitate patients with acute myocardial infarction and circulatory collapse, in order to attempt urgent percutaneous coronary stent treatment (group 2). Primary success was achieved in 66 patients from group 1 (97%). One patient died and another had a myocardial infarction. After 28 +/- 19 months of follow-up, 20 patients (30%) from group 1 had a major adverse cardiac event. The remaining 46 patients (68%) are alive, with persistent clinical benefit. In group 2, reperfusion and stent treatment was always achieved. However, 14 patients had an in-hospital death. Five patients from group 2 had a major adverse event at follow-up (47 +/- 20 months). Nine patients (38%) remain at present in functional class I-II. Percutaneous CPS provides safe conditions to accomplish stent coronary revascularization in high-risk patients and those with acute myocardial infarction and failing heart. Long-term follow-up of survivors shows persistent benefit in most patients.
经皮心肺支持（CPS）已被证明是一种对接受经皮球囊血管成形术的高危冠心病患者有价值的技术。自1994年5月以来，我们在92例患者中联合使用了CPS和冠状动脉支架血管重建术。其中68例，CPS被用作预防性措施（第1组）；其余24例，CPS被用作紧急措施，以稳定甚至复苏急性心肌梗死和循环衰竭的患者，以便尝试紧急经皮冠状动脉支架治疗（第2组）。第1组66例患者取得了初步成功（97%）。1例患者死亡，另1例发生心肌梗死。经过28±19个月的随访，第1组20例患者（30%）发生了主要不良心脏事件。其余46例患者（68%）存活，仍有持续的临床获益。在第2组中，再灌注和支架治疗均成功完成。然而，14例患者在住院期间死亡。第2组5例患者在随访时（47±20个月）发生了主要不良事件。目前9例患者（38%）的心功能分级为I-II级。经皮CPS为高危患者以及急性心肌梗死和心力衰竭患者完成支架冠状动脉血管重建提供了安全条件。幸存者的长期随访显示，大多数患者仍有持续获益。
