Kashiwa Koichi, Nishimura Takashi, Saito Aya, Kubo Hitoshi, Fukaya Aoi, Tamai Hisayoshi, Yambe Tomoyuki, Kyo Shunei, Ono Minoru
Department of Medical Engineering, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
J Artif Organs. 2012 Jun;15(2):207-10. doi: 10.1007/s10047-012-0632-x. Epub 2012 Feb 23.
Since left heart bypass or biventricular circulatory assist with an extracorporeal centrifugal pump as a bridge to decision or recovery sometimes requires long-time support, the long-term durability of extracorporeal centrifugal pumps is crucial. The Rotaflow Centrifugal Pump(®) (MAQUET Cardiopulmonary AG, Hirrlingen, Germany) is one of the centrifugal pumps available for long-term use in Japan. However, there have been few reports of left heart bypass or biventricular circulatory support over the mid-term. This is a case report of left heart bypass support with the Rotaflow Centrifugal Pump(®) as a bridge to decision and recovery for an adult patient who could not be weaned from cardiopulmonary bypass and percutaneous cardiopulmonary support after cardiac surgery. We could confirm that the patient's consciousness level was normal; however, the patient could not be weaned from the left heart bypass support lasting 1 month. Therefore, the circulatory assist device was switched to the extracorporeal Nipro ventricular assist device (VAD). This time, left heart bypass support could be maintained for 30 days using a single Rotaflow Centrifugal Pump(®). There were no signs of hemolysis during left heart bypass support. The Rotaflow Centrifugal Pump(®) itself may be used as a device for a bridge to decision or recovery before using a VAD in cardiogenic shock patients.
由于使用体外离心泵进行左心旁路或双心室循环辅助作为决策或恢复的桥梁有时需要长期支持，因此体外离心泵的长期耐用性至关重要。罗塔流离心泵（Rotaflow Centrifugal Pump®）（德国希灵根的迈柯唯心肺有限公司）是日本可用于长期使用的离心泵之一。然而，关于中期左心旁路或双心室循环支持的报道很少。这是一例使用罗塔流离心泵（Rotaflow Centrifugal Pump®）进行左心旁路支持的病例报告，该患者为一名成年患者，心脏手术后无法脱离体外循环和经皮心肺支持，以此作为决策和恢复的桥梁。我们可以确认患者意识水平正常；然而，患者无法脱离持续1个月的左心旁路支持。因此，循环辅助装置切换为体外尼普洛心室辅助装置（VAD）。此次，使用单个罗塔流离心泵（Rotaflow Centrifugal Pump®），左心旁路支持可维持30天。在左心旁路支持期间没有溶血迹象。在对心源性休克患者使用VAD之前，罗塔流离心泵（Rotaflow Centrifugal Pump®）本身可作为决策或恢复的桥梁装置。
