一名植入HeartWare左心室辅助装置的患者接受微创右心室辅助装置植入术

Minimally Invasive Right Ventricular Assist Device Implantation in a Patient with HeartWare left ventricular Assist Device.

作者信息

Maxhera Bujar, Albert Alexander, Westenfeld Ralf, Boeken Udo, Lichtenberg Artur, Saeed Diyar

机构信息

From the *Clinic for Cardiovascular Surgery, Heinrich-Heine University of Düsseldorf, Düsseldorf, Germany; and †Clinic for Cardiology, Pneumology and Angiology, Heinrich-Heine University of Düsseldorf, Düsseldorf, Germany.

出版信息

ASAIO J. 2015 Nov-Dec;61(6):e42-3. doi: 10.1097/MAT.0000000000000250.

DOI:10.1097/MAT.0000000000000250

PMID:25914955

Abstract

Many centers reported positive outcome after left ventricular assist devices (LVADs) implantation using a minimally invasive approach. The main drawback of this minimally invasive approach is the feasibility of right ventricular assist device (RVAD) implantation with direct cannulation of the pulmonary artery in cases of perioperative right ventricular failure (RVF). We report our experience with a 41-year-old male patient who was supported with a temporary RVAD using J-sternotomy approach for RVF after LVAD implantation. No technical issue was encountered, and the patient's condition stabilized immediately after RVAD implantation. However, several days later, the patient developed severe septic shock caused by pneumonia and died on the postoperative day 15 after RVAD implantation.

摘要

许多中心报告称，采用微创方法植入左心室辅助装置（LVAD）后取得了积极的效果。这种微创方法的主要缺点是，在围手术期发生右心室衰竭（RVF）的情况下，通过直接插管肺动脉来植入右心室辅助装置（RVAD）的可行性。我们报告了一名41岁男性患者的病例，该患者在LVAD植入术后因RVF采用J形胸骨切开术使用临时RVAD进行支持治疗。未遇到技术问题，RVAD植入后患者病情立即稳定。然而，几天后，患者因肺炎引发严重感染性休克，并在RVAD植入术后第15天死亡。