Sakata Yoshihito
Division of Cardiology, Ikegami General Hospital, Ikegami 6-1-19, Ota, Tokyo, 146-0082, Japan.
Cardiovasc Interv Ther. 2017 Oct;32(4):430-435. doi: 10.1007/s12928-016-0453-6. Epub 2017 Jan 2.
A 90-year-old female with severe peripheral vascular disease developed cardiogenic shock (CS) due to critical aortic stenosis (AS). The balloon aortic valvuloplasty was emergently performed via transvenous and transseptal antegrade approach (ante-BAV), which saved arterial accesses for intra-aortic balloon pump (IABP) and enabled us to use the Inoue balloon. The IABP augmented systemic perfusions and controlled left heart filling pressures. Multiple times of inflations with stepwisely increased balloon diameters were performed under IABP support (ante-Inoue-BAV + IABP), resulting in remarkable improvements both in clinical and hemodynamic conditions. The ante-Inoue-BAV + IABP efficaciously and safely treats elderly CS-AS for an emergent hemodynamic stabilization.
一名90岁患有严重外周血管疾病的女性因严重主动脉瓣狭窄（AS）发生心源性休克（CS）。通过经静脉和经房间隔顺行途径（顺行球囊主动脉瓣成形术）紧急实施了球囊主动脉瓣成形术，这为主动脉内球囊反搏（IABP）保留了动脉通路，并使我们能够使用Inoue球囊。IABP增强了全身灌注并控制了左心充盈压。在IABP支持下（顺行Inoue球囊主动脉瓣成形术+IABP）多次使用逐步增加直径的球囊进行扩张，使临床和血流动力学状况均得到显著改善。顺行Inoue球囊主动脉瓣成形术+IABP能有效且安全地治疗老年CS-AS患者，实现紧急血流动力学稳定。
