Loebe M, Zade Asfahani W H, Petrov G P, Kleiman N S, Torre-Amione G
Methodist DeBakey Heart Center, Houston, TX 77030, United States.
Thorac Cardiovasc Surg. 2009 Feb;57(1):50-2. doi: 10.1055/s-2008-1038407. Epub 2009 Jan 23.
Decompensated aortic valve stenosis is a life-threatening condition. Aortic valve replacement in patients with cardiogenic shock due to critical aortic stenosis is a high-risk procedure and is associated with increased operative mortality. We describe the clinical course of a patient who was transferred to our institution in cardiogenic shock and with multiple organ failure, due to decompensated aortic valve stenosis. The patient received the percutaneous left ventricular assist device TandemHeart which has been developed for short-term cardiac support. After hemodynamic improvement the patient underwent successful aortic valve replacement. The device was left in place until the patient had recovered from surgery. The excellent outcome suggests that a perioperative mechanical support might greatly improve the safety of aortic valve replacement in the presence of cardiogenic shock.
失代偿性主动脉瓣狭窄是一种危及生命的疾病。因严重主动脉瓣狭窄导致心源性休克的患者进行主动脉瓣置换术是一项高风险手术，且与手术死亡率增加相关。我们描述了一名因失代偿性主动脉瓣狭窄而在心源性休克且伴有多器官功能衰竭的情况下被转至我院的患者的临床病程。该患者接受了为短期心脏支持而研发的经皮左心室辅助装置TandemHeart。在血流动力学改善后，患者成功接受了主动脉瓣置换术。该装置一直保留在位直至患者从手术中恢复。这一良好结果表明，围手术期机械支持可能会大大提高存在心源性休克时主动脉瓣置换术的安全性。
