Weis Ricardo A, Devaleria Patrick A, Koushik Sarang, Ramakrishna Harish
Department of Anesthesiology, Division of Cardiovascular and Thoracic Anesthesiology, Mayo Clinic Hospital, Phoenix, Arizona, USA.
Ann Card Anaesth. 2015 Oct-Dec;18(4):467-73. doi: 10.4103/0971-9784.166441.
Advances in medical and surgical care have made it possible for an increasing number of patients with Congenital Heart disease (CHD) to live into adulthood. Transposition of the great vessels (TGV) is the most common cyanotic congenital cardiac disease where the right ventricle serves as systemic ventricle. It is not uncommon for these patients to have systemic ventricular failure requiring transplantation.
Hemodynamic decompensation in these patients can be swift and difficult to manage. Increasingly percutaneous LVAD's such as the Impella (Abiomed, Mass, USA) are gaining popularity in these situations owing to their relative ease of placement, both in and outside of the operating room.
In this paper we demonstrate that Impella (IMP) CP placement through the axillary artery approach shows to be suitable option for short term cardiac support and improvement of end organ perfusion in anticipation of cardiac transplantation.
医学和外科护理的进步使越来越多的先天性心脏病(CHD)患者能够活到成年。大动脉转位(TGV)是最常见的青紫型先天性心脏病,其中右心室作为体循环心室。这些患者出现需要移植的体循环心室衰竭并不罕见。
这些患者的血流动力学失代偿可能迅速且难以处理。越来越多的经皮左心室辅助装置,如Impella(美国马萨诸塞州的Abiomed公司生产),由于其在手术室内外相对易于放置,在这些情况下越来越受欢迎。
在本文中,我们证明通过腋动脉途径放置Impella(IMP)CP是短期心脏支持以及在预期心脏移植时改善终末器官灌注的合适选择。