Broderick T M, Bourdillon P D, Dalsing M, Faris J V, Dillon J C
Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis.
Indiana Med. 1990 Oct;83(10):716-21.
We report the safety and feasibility of the first three patients using cardiopulmonary bypass support at the Indiana University Medical Center during PTCA. All patients had severe left ventricular dysfunction. Cannulation was performed using 18- or 20-French cannulae of the femoral vessels, either surgically or percutaneously. After heparinization with an activated clotting time of greater than 450 seconds, cardiopulmonary bypass was instituted using the Bard CPS system. Flows ranged from 3.0 to 4.3 L/min. Normasol was used to prime the pump. Blood was retransfused back into the patient at the end of the procedure. Bleeding was a problem in case 1 at the arterial cannulation site and subsequently was corrected for cases 2 and 3. Coronary angioplasties were deemed technically successful. We conclude that high-risk angioplasty can be performed in patients with poor left ventricular function using cardiopulmonary bypass support in the cardiac catheterization laboratory. Further study is indicated.
我们报告了印第安纳大学医学中心在经皮冠状动脉腔内血管成形术（PTCA）期间对前三例患者使用体外循环支持的安全性和可行性。所有患者均有严重的左心室功能障碍。采用18或20法式股血管插管，通过手术或经皮方式进行插管。在用肝素化使活化凝血时间大于450秒后，使用巴德CPS系统建立体外循环。流量范围为3.0至4.3升/分钟。使用Normasol预充泵。手术结束时将血液回输到患者体内。病例1在动脉插管部位出现出血问题，随后病例2和3的出血问题得到纠正。冠状动脉血管成形术在技术上被认为是成功的。我们得出结论，在心脏导管实验室中，对于左心室功能较差的患者，可以使用体外循环支持进行高危血管成形术。需要进一步研究。
