Akamatsu H, Sakakibara T, Mishima M, Kodama K, Matsuwaka R, Matsuda H
Cardiovascular Division, Osaka Police Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Oct;38(10):2122-7.
A left ventricular assist device (LVAD) was applied to a patient who had profound left ventricular failure following extended myocardial infarction caused by the left main trunk obstruction. The patient was a 61-year-old man, who had severe chest distress and was admitted 11 hours after the onset of the symptom. At the time of admission, he was already in cardiogenic shock. The emergent coronary angiography showed complete obstruction of the left main trunk and the intact right coronary artery which had no collateral flow to the left coronary artery. The intraaortic balloon pumping (IABP) was started bu could not maintain the satisfied circulation. Then a LVAD was applied to the patient 5 days after the onset. The LVAD maintained the normal circulation and prohibited exaspiration of organ failure. 19 days after the onset, scartectomy and A-C bypass to LAD was performed. The patient could not be weaned from LVAD and died of right ventricular failure following ventricular arrhythmia 20 days after the installation of LVAD. The use of LVAD for nonoperative cardiogenic shock is rare. Circulatory support with a LVAD in the treatment of a patient in cardiogenic shock following a acute myocardial infarction was considered useful.
一名左主干阻塞导致广泛心肌梗死后出现严重左心室衰竭的患者接受了左心室辅助装置（LVAD）治疗。患者为61岁男性，有严重胸痛症状，症状发作11小时后入院。入院时，他已处于心源性休克状态。急诊冠状动脉造影显示左主干完全阻塞，右冠状动脉完好但无向左冠状动脉的侧支血流。开始进行主动脉内球囊反搏（IABP），但无法维持满意的循环。症状发作5天后对患者应用了LVAD。LVAD维持了正常循环并防止了器官衰竭的加重。症状发作19天后，进行了瘢痕切除术和前降支冠状动脉搭桥术。患者无法脱离LVAD，在LVAD植入20天后因室性心律失常继发右心室衰竭死亡。将LVAD用于非手术性心源性休克的情况很少见。在急性心肌梗死后心源性休克患者的治疗中，使用LVAD进行循环支持被认为是有用的。
