Shawl F A, Domanski M J, Wish M H, Davis M
Department of Interventional Cardiology, Washington Adventist Hospital, Takoma Park, MD 20912.
Am Heart J. 1990 Jul;120(1):195-203. doi: 10.1016/0002-8703(90)90178-z.
A safe and easily applied technique of percutaneous cardiopulmonary bypass support has been developed for use in the cardiac catheterization laboratory. The importance of this technique lies in its ability to maintain hemodynamic stability during high risk interventional procedures regardless of intrinsic cardiac function. Venous and arterial cannulas (18F) are inserted percutaneously over a stiff guide wire after sequential dilatation with 12F and 14F dilators. Bypass flow rates of up to 5 L/min can be achieved. This technique can be applied to support patients with cardiac arrest, hemodynamic collapse after abrupt closure during coronary angioplasty, and cardiogenic shock, as well as those undergoing high-risk elective coronary angioplasty. This form of support also permits transport of the patient to the operating room in a stable condition after an unsuccessful angioplasty. The complications are mostly related to cannula removal and can be minimized by the use of a proper technique. Although the ultimate role of this new technique remains to be completely defined, it appears that it will expand the patient population for whom coronary interventions can be applied.
一种安全且易于应用的经皮心肺旁路支持技术已被研发出来，用于心脏导管实验室。该技术的重要性在于，无论心脏固有功能如何，它都能够在高风险介入手术期间维持血流动力学稳定。在用12F和14F扩张器依次扩张后，经皮在硬导丝上插入静脉和动脉套管（18F）。可实现高达5升/分钟的旁路流速。该技术可应用于支持心脏骤停患者、冠状动脉成形术期间突然闭塞后出现血流动力学崩溃的患者、心源性休克患者，以及那些接受高风险择期冠状动脉成形术的患者。这种支持形式还允许在血管成形术失败后将患者稳定地转运至手术室。并发症大多与套管拔除有关，通过使用适当的技术可将其降至最低。尽管这项新技术的最终作用仍有待完全明确，但似乎它将扩大可应用冠状动脉介入治疗的患者群体。
