Piedmont Heart Institute, Piedmont Hospital, Atlanta, Georgia 30309, USA.
J Heart Lung Transplant. 2010 Jan;29(1):93-5. doi: 10.1016/j.healun.2009.09.015.
We describe the case of a 36-year-old man with acute cardiac transplant rejection bridged to recovery using simultaneous Impella 2.5 and TandemHeart percutaneous support devices. The patient underwent orthotopic cardiac transplantation 2 years earlier, and presented to our hospital with allograft failure 7 days after non-compliance with tacrolimus. Because of persistent cardiogenic shock despite intra-aortic balloon and inotropic support, we implanted an Impella 2.5 percutaneous assist device for left ventricular support. Persistent right ventricular dysfunction necessitated insertion of a TandemHeart for right ventricular support. After a course of intravenous solumedrol and anti-thymocyte globulin, both the Impella and TandemHeart devices were successfully weaned and removed. Nine months later, his left ventricular ejection fraction had stabilized from 10% to 55%.
我们描述了一例 36 岁男性患者，因急性心脏移植排斥反应，使用同时植入的 Impella 2.5 和 TandemHeart 经皮支持设备进行桥接恢复。该患者在 2 年前接受了原位心脏移植，在他不遵医嘱使用他克莫司后 7 天出现同种异体移植物衰竭，并被收入我院。尽管进行了主动脉内球囊反搏和正性肌力支持，他仍持续出现心源性休克，因此我们植入了 Impella 2.5 经皮辅助装置以支持左心室。持续的右心室功能障碍需要插入 TandemHeart 以支持右心室。经过静脉注射甲泼尼龙和抗胸腺细胞球蛋白治疗后，Impella 和 TandemHeart 设备均成功脱机并移除。9 个月后，他的左心室射血分数从 10%稳定至 55%。
