Dahdouh Ziad, Roule Vincent, Sabatier Rémi, Lognoné Thérèse, Labombarda Fabien, Pellissier Arnaud, Belin Annette, Ivascau Calin, Buklas Dimitrios, Massetti Massimo, Grollier Gilles
Department of Interventional Cardiology, CHU de Caen, Caen, France.
Cardiovasc Revasc Med. 2012 Jul-Aug;13(4):241-5. doi: 10.1016/j.carrev.2012.02.007. Epub 2012 Apr 3.
In patients with cardiogenic shock, the Extra-Corporeal Life Support (ECLS) has been shown to be lives saving. But, in some situations, it proves inadequate for the discharge of the left heart. Several device-based techniques have been proposed to decompress the left side either surgically or percutaneously, each of them with the proper potential risks and complications. One technique, the percutaneous blade and balloon atrioseptostomy that requires transseptal catheter based experience and consists of creating an atrial septal defect (ASD) could be an elegant technique as an "add on" to the classic assistance making together a bridge to partial recovery or to heart transplantation. Herein, we present a case of an adult patient who presented with inaugural resistant cardiac arrest with a thrombotic occlusion of the left anterior descending artery (LAD) who required Extra-Corporeal Life Support, thrombus aspiration, stenting of the culprit lesion, and percutaneous blade and balloon atrioseptostomy to bridge "safely" to the heart transplantation.
在心源休克患者中,体外生命支持(ECLS)已被证明可挽救生命。但是,在某些情况下,它被证明不足以解除左心负担。已经提出了几种基于设备的技术,通过手术或经皮方式对左侧进行减压,每种技术都有相应的潜在风险和并发症。一种技术是经皮刀片和球囊房间隔造口术,该技术需要基于经间隔导管的经验,包括制造一个房间隔缺损(ASD),作为经典辅助手段的“附加”技术,它可能是一种巧妙的技术,共同搭建通往部分恢复或心脏移植的桥梁。在此,我们报告一例成年患者,该患者首次出现难治性心脏骤停,左前降支动脉(LAD)血栓闭塞,需要体外生命支持、血栓抽吸、罪犯病变支架置入以及经皮刀片和球囊房间隔造口术,以“安全地”过渡到心脏移植。