Gregoric Igor D, Bieniarz Mark C, Arora Harvinder, Frazier O H, Kar Biswajit, Loyalka Pranav
Department of Cardiopulmonary Transplantation, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77225-0345, USA.
Tex Heart Inst J. 2008;35(1):46-9.
Complications of acute myocardial infarction have decreased in number and severity due to the application of early thrombolytic coronary revascularization techniques. Nonetheless, the mortality rate associated with these complications remains high. Ventricular septal rupture is one of the complications that can occur after myocardial infarction. In the treatment of postinfarction ventricular septal rupture, the need for immediate closure to avoid acute hemodynamic compromise must be weighed against the need for delayed repair to enable the acutely necrotic myocardium to organize and to develop fibrotic tissue. We report the use of a minimally invasive TandemHeart percutaneous ventricular assist device for 18 days in a 58-year-old man who experienced postinfarction ventricular rupture. The hemodynamic support provided by the device allowed time for left ventricular recovery before attempted percutaneous closure of the ventricular septal rupture and after definitive surgical repair of the septal defect. To our knowledge, this is the 1st reported use of the TandemHeart for support before and after repair of a postinfarction ventricular septal rupture.
由于早期溶栓冠状动脉血运重建技术的应用，急性心肌梗死的并发症在数量和严重程度上均有所减少。尽管如此，与这些并发症相关的死亡率仍然很高。室间隔破裂是心肌梗死后可能出现的并发症之一。在治疗心肌梗死后室间隔破裂时，必须权衡立即闭合以避免急性血流动力学损害的必要性与延迟修复以使急性坏死心肌组织化并形成纤维化组织的必要性。我们报告了一名58岁男性心肌梗死后室间隔破裂患者使用微创串联式人工心脏经皮心室辅助装置18天的情况。该装置提供的血流动力学支持为尝试经皮闭合室间隔破裂之前以及最终手术修复间隔缺损之后的左心室恢复留出了时间。据我们所知，这是首次报道在心肌梗死后室间隔破裂修复前后使用串联式人工心脏进行支持。
