Morimoto Yoshihisa, Sugimoto Takaki, Haba Fumiya, Sakahira Hideki
Division of Cardiovascular Surgery, Awaji Medical Center, Hyogo, Japan.
Division of Cardiovascular Surgery, Awaji Medical Center, Hyogo, Japan.
Int J Surg Case Rep. 2016;26:131-3. doi: 10.1016/j.ijscr.2016.07.032. Epub 2016 Jul 27.
There are many publications reporting the use of TachoSil sheets for sutureless repair. Trauma doctors have recently reported that chitosan-based sheets can efficiently achieve hemostasis for active bleeding.
An 85-year-old man was diagnosed with left ventricle free wall rupture that caused cardiac tamponade and cardiogenic shock. Extracorporeal membrane oxygenator (ECMO) was started immediately and surgical repair was planned. Bleeding occurred from a 1-cm tear in the center of the necrotic area in the territory of the left circumflex artery. The tear was treated with a chitosan-based HemCon Bandage. After hemostasis of the myocardium was achieved, the bandage was peeled off and a patch repair was performed using collagen fleece with fibrinogen-based impregnation. His condition subsequently improved. The tracheal tube was extubated and ECMO was removed 2days after the surgery. One month later, the patient had no complications at his postoperative follow-up visit.
To our knowledge, this is the first report of a hybrid patch repair utilizing chitosan-based sheets for a left ventricle rupture after myocardial infarction. Further studies are necessary to evaluate the short- and long-term efficacy of this procedure, and these results must be compared with those of classical surgical repairs.
The new hybrid sutureless patch utilizing chitosan was demonstrated as safe, easy and effective.
有许多出版物报道了使用速即纱片进行无缝合修复。创伤科医生最近报告称，基于壳聚糖的片材可有效实现活动性出血的止血。
一名85岁男性被诊断为左心室游离壁破裂，导致心脏压塞和心源性休克。立即启动体外膜肺氧合（ECMO）并计划进行手术修复。在左旋支动脉区域的坏死区域中心有一处1厘米的裂口出血。用基于壳聚糖的HemCon绷带处理该裂口。在心肌实现止血后，揭下绷带，使用浸有纤维蛋白原的胶原绒进行补片修复。患者病情随后好转。术后2天拔除气管导管并撤掉ECMO。1个月后，患者术后随访无并发症。
据我们所知，这是首次报道使用基于壳聚糖的片材进行心肌梗死后左心室破裂的混合补片修复。有必要进行进一步研究以评估该手术的短期和长期疗效，并且必须将这些结果与传统手术修复的结果进行比较。
新型壳聚糖混合无缝合补片被证明是安全、简便且有效的。
