Gon Shigeyoshi, Suematsu Yoshihito, Morizumi Sei, Shimizu Tsuyoshi
Cardiovascular Surgery, Tsukuba Memorial Hospital, 1187-299 Kaname, Tsukuba, Ibaraki, Japan.
J Artif Organs. 2011 Sep;14(3):257-60. doi: 10.1007/s10047-011-0575-7. Epub 2011 May 28.
A 19-year-old woman suffered fulminant myocarditis owing to a mycoplasma infection and was inserted with an intra-aortic balloon pump and a percutaneous cardiopulmonary support. Antibiotics and gamma globulin were administered, however, the patient's cardiac function did not recover, and the TOYOBO ventricular assist device (VAD) was implanted. She had rehabilitation training such as maintaining a standing position at the bedside and walking in the hospital, and a hospital outing program to a family restaurant was conducted two times with the VAD. The patient wished to attend the coming-of-age ceremony in Tachikawa city, which is 3 h away from our hospital by car. Therefore, we planned the program including a night stay at her home. The patient and her family fully understood the risks and wished to participate in the sleepover program. In preparing for the sleepover, the patient and her family learned to operate the VAD, and she was able to move to the lavatory and through the house with the help of only her family. A physician and a clinical engineer stayed at her house for infusion of antibiotics and management of sudden changes. There was no adverse event. In Japan, the community support of patients with VAD is not yet established, and we hope that our experience becomes a help to support return to society for patients with VAD.
一名19岁女性因支原体感染患上暴发性心肌炎，接受了主动脉内球囊泵置入及经皮心肺支持治疗。给予了抗生素和丙种球蛋白，但患者的心功能未恢复，遂植入了东洋纺心室辅助装置（VAD）。她接受了诸如在床边站立及在医院内行走等康复训练，并在使用VAD的情况下两次前往家庭餐厅进行医院外出活动。患者希望参加距离我院驾车3小时路程的立川市成人礼。因此，我们制定了包括在她家过夜的计划。患者及其家人充分了解风险并希望参加过夜活动。在为过夜做准备时，患者及其家人学会了操作VAD，并且她仅在家人帮助下就能前往厕所并在屋内走动。一名医生和一名临床工程师留在她家进行抗生素输注及应对突发变化。未发生不良事件。在日本，VAD患者的社区支持尚未建立，我们希望我们的经验能有助于支持VAD患者回归社会。
