Kiernan Michael S, Krishnamurthy Barath, Kapur Navin K
Tufts Medical Center, Division of Cardiology, Boston, MA 02111, USA.
J Invasive Cardiol. 2010 Feb;22(2):E23-6.
Management of right heart failure in acute myocardial infarction (AMI) includes emergent reperfusion of the infarct-related artery, fluid resuscitation, vasopressor and inotropic support, and trans-venous pacing in the presence of high-grade atrio-ventricular conduction block. Historically, mechanical support for right ventricular failure after an AMI has been limited to intra-aortic balloon pump (IABP) counterpulsation or surgically placed ventricular assist devices. Recently, a percutaneous right ventricular assist device (pRVAD, TandemHeart; CardiacAssist Inc., Pittsburgh, Pennsylvania) has offered an intermediate alternative for patients with refractory right heart failure in the setting of AMI. We describe a novel approach to pRVAD implantation via the right internal jugular vein in the setting of cardiogenic shock secondary to an acute inferior myocardial infarction.
急性心肌梗死（AMI）所致右心衰竭的管理包括梗死相关动脉的紧急再灌注、液体复苏、血管升压药和正性肌力支持，以及在存在高度房室传导阻滞时进行经静脉起搏。从历史上看，AMI后右心室衰竭的机械支持仅限于主动脉内球囊泵（IABP）反搏或手术植入的心室辅助装置。最近，一种经皮右心室辅助装置（pRVAD，TandemHeart；CardiacAssist Inc.，宾夕法尼亚州匹兹堡）为AMI合并难治性右心衰竭的患者提供了一种中间替代方案。我们描述了一种在急性下壁心肌梗死继发心源性休克的情况下，经右颈内静脉植入pRVAD的新方法。
