Lim Kyunghee, Choi Jin-Oh, Yang Jeong Hoon, Park Seung-Jung, Kim Sun Hwa, Kang Jiseok, Joh Hyun Sung, Shin Sun Hye
Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean Circ J. 2017 Jan;47(1):132-135. doi: 10.4070/kcj.2016.0176. Epub 2016 Dec 23.
65-year-old woman was admitted to our hospital with acute decompensated heart failure with reduced left ventricular ejection fraction and severe mitral regurgitation. Electrocardiography revealed a typical left bundle branch block and atrial fibrillation. Her condition deteriorated despite administering high-doses of inotropes and vasopressors. Pending a decision to therapy, venoarterial extracorporeal membrane oxygenation (ECMO) was performed when the patient underwent a cardiogenic shock. Although the hemodynamic status stabilized with ECMO support, weaning the patient from ECMO was not possible. Thus, we decided to perform cardiac resynchronization with defibrillator implantation as a "rescue" therapy. Five days post-implantation, the patient was successfully weaned from ECMO.
一名65岁女性因急性失代偿性心力衰竭伴左心室射血分数降低和严重二尖瓣反流入住我院。心电图显示典型的左束支传导阻滞和心房颤动。尽管给予了大剂量的正性肌力药物和血管加压药,她的病情仍恶化。在决定治疗方案期间,当患者发生心源性休克时,进行了静脉-动脉体外膜肺氧合(ECMO)治疗。尽管在ECMO支持下血流动力学状态稳定,但患者无法脱离ECMO。因此,我们决定进行心脏再同步化并植入除颤器作为“挽救”治疗。植入后五天,患者成功脱离ECMO。