Wahlers T, Frimpong-Boateng K, Haverich A, Schäfers H J, Fieguth H G, Coppola R, Jurmann M, Borst H G
Thorac Cardiovasc Surg. 1986 Dec;34(6):389-90. doi: 10.1055/s-2007-1022180.
A 37-year-old man underwent cardiac transplantation for diffuse coronary artery disease and malignant arrhythmias. During the harvesting of the donor heart slight distention of the left ventricle was present due to insufficiency of the aortic valve. After explantation of the graft, fusion of 2 cusps was found and a commissurotomy of the aortic valve was performed and the graft transplanted. Despite maximum inotropic support immediate graft failure and aortic insufficiency was present and discontinuation of cardiopulmonary bypass (CPB) was impossible. After replacement of the aortic valve using a bioprosthesis and implantation of an intraaortic balloon-pump, low cardiac output persisted and CPB had to be continued. After 11 hours of normothermic cardiopulmonary bypass and intraaortic balloon-pumping a second graft became available and was retransplanted successfully. The postoperative course was uneventful and the patient remains well 3 months after the operation.
一名37岁男性因弥漫性冠状动脉疾病和恶性心律失常接受了心脏移植手术。在获取供体心脏过程中，由于主动脉瓣功能不全，左心室出现轻度扩张。在移植心脏移出后，发现两个瓣叶融合，遂进行了主动脉瓣交界切开术，然后进行了心脏移植。尽管给予了最大剂量的正性肌力支持，但仍出现了即刻移植失败和主动脉瓣关闭不全，无法停止体外循环（CPB）。在使用生物假体置换主动脉瓣并植入主动脉内球囊泵后，心输出量仍然很低，CPB不得不继续进行。在常温体外循环和主动脉内球囊泵辅助11小时后，获得了第二个供体心脏并成功再次移植。术后过程顺利，患者术后3个月情况良好。
