Ota Takeyoshi, Okada Kenji, Kano Hiroya, Okita Yutaka
Department of Cardiovascular Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Interact Cardiovasc Thorac Surg. 2007 Jun;6(3):270-3. doi: 10.1510/icvts.2006.146209. Epub 2007 Feb 14.
Infective endocarditis is a life threatening disease with high mortality and morbidity, including brain infarction concomitant with intracranial hemorrhage. Generally, patients with a recent intracranial hemorrhage are believed to be a contraindication to undergo cardiac surgery with cardiopulmonary bypass. However, some patients with infective endocarditis occasionally require an unavoidable emergent surgery because of uncontrollable heart failure or on-going thromboembolism even if complicated by intracranial hemorrhage. In this study, a cardiopulmonary bypass strategy using nafamostat mesilate as an anticoagulant for such patients is discussed based on three cases we experienced.
感染性心内膜炎是一种危及生命的疾病，死亡率和发病率都很高，包括伴有颅内出血的脑梗死。一般来说，近期有颅内出血的患者被认为是接受体外循环心脏手术的禁忌证。然而，一些感染性心内膜炎患者即使并发颅内出血，由于无法控制的心力衰竭或持续的血栓栓塞，偶尔也需要进行不可避免的急诊手术。在本研究中，基于我们所经历的三例病例，讨论了使用甲磺酸萘莫司他作为抗凝剂的体外循环策略用于此类患者。
