经皮心室辅助装置及体外膜肺氧合支持用于一名心肌梗死后室间隔缺损合并游离壁破裂的患者

Percutaneous ventricular assist device and extracorporeal membrane oxygenation support in a patient with postinfarction ventricular septal defect and free wall rupture.

作者信息

Gregoric Igor D, Mesar Tomaz, Kar Biswajit, Nathan Sriram, Radovancevic Rajko, Patel Manish, Loyalka Pranav

机构信息

Department of Cardiopulmonary Transplantation and the Center for Cardiac Support, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas, USA.

出版信息

Heart Surg Forum. 2013 Jun;16(3):E150-1. doi: 10.1532/HSF98.20121123.

DOI:10.1532/HSF98.20121123

PMID:23803239

Abstract

We describe the case of a 54-year-old woman with a postinfarction ventricular septal defect (VSD) and ventricular free wall rupture who was stabilized with a percutaneous ventricular assist device (pVAD) to allow for myocardial infarct stabilization. Following the rupture of the right ventricular free wall and cardiopulmonary arrest on hospital day 10, pVAD support was promptly converted to extracorporeal membrane oxygenation (ECMO) support for stabilization. After surgical repair was completed, pVAD support was continued for 4 days to allow recovery. The patient was discharged on postoperative day 11 and is alive and well 4 years later. Postinfarction VSD with free wall rupture may be salvaged with pVAD and ECMO support.

摘要

我们描述了一例54岁女性患者，其患有心肌梗死后室间隔缺损（VSD）及心室游离壁破裂，通过经皮心室辅助装置（pVAD）实现病情稳定，以促进心肌梗死的稳定。在第10个住院日出现右心室游离壁破裂及心脏骤停后，pVAD支持迅速转换为体外膜肺氧合（ECMO）支持以实现病情稳定。手术修复完成后，继续进行pVAD支持4天以促进恢复。患者于术后第11天出院，4年后仍然健在且状况良好。心肌梗死后合并游离壁破裂的VSD可通过pVAD和ECMO支持得到救治。