Bottio Tomaso, Bejko Jonida, Guariento Alvise, Tarzia Vincenzo, Pittarello Demetrio, Gerosa Gino
Department of Cardiology and Cardiovascular Surgery, University of Padova Medical School, Padova, Italy.
J Cardiovasc Med (Hagerstown). 2016 Feb;17(2):160-4. doi: 10.2459/JCM.0000000000000191.
We describe the surgical technique and treatment of a 59-year-old male with cardiogenic shock, who underwent a minimally invasive off-pump ventricular assist device (VAD) implantation with the aid of paravertebral regional analgesia in bilateral mini-thoracotomies as first procedure described in the literature. He was extubated soon after the procedure, in the operating room, with the aim to reduce the right ventricle impairment. These issues are particularly true for patients suffering from pulmonary hypertension and disease, in whom the shortest time of postoperative intubation is fundamental to allow self-inotropic support and recovery of the right ventricle. We illustrate how a minimally invasive implant may improve the clinical outcomes of VAD patients shortening their return time to active life.
我们描述了一名59岁心源性休克男性患者的手术技术及治疗情况。该患者在双侧小切口开胸手术中借助椎旁区域镇痛，接受了微创非体外循环心室辅助装置（VAD）植入术，这是文献中首次描述的此类手术。术后在手术室很快拔除气管插管，目的是减轻右心室损伤。对于患有肺动脉高压和疾病的患者来说尤其如此，在这类患者中，术后最短的插管时间对于实现自我正性肌力支持和右心室恢复至关重要。我们阐述了微创植入如何改善VAD患者的临床结局，缩短其恢复积极生活的时间。
