Kazui Toshinobu, Tran Phat L, Pilikian Tia R, Marsh Katie M, Runyan Raymond, Konhilas John, Smith Richard, Khalpey Zain I
Department of Surgery, Division of Cardiothoracic Surgery, University of Arizona, Tucson, AZ, USA.
College of Medicine - Tucson, University of Arizona, Tucson, AZ, USA.
J Cardiothorac Surg. 2017 Sep 7;12(1):80. doi: 10.1186/s13019-017-0648-7.
Temporary mechanical circulatory support device without sternotomy has been highly advocated for severe cardiogenic shock patient but little is known when coupled with amniotic stem cell therapy.
This case reports the first dual therapy of temporary left ventricular extracorporeal device CentriMag with distal banding technique and human amniotic stem cell injection for treating a severe refractory cardiogenic shock of an 68-year-old female patient. A minimally-invasive off-pump LVAD was established by draining from the left ventricle and returning to the right axillary artery with distal arterial banding to prevent right upper extremity hyperperfusion. Amniotic stem cells were injected intramyocardially at the left ventricular apex, lateral wall, inferior wall, and right subclavian vein.
The concomitant use of the temporary minimally-invasive off-pump CentriMag placement and stem cell therapy not only provided an alternative to cardiopulmonary bypass and full-median sternotomy procedures but may have also synergistically enhanced myocardial reperfusion and regeneration.
对于严重心源性休克患者，不进行胸骨切开术的临时机械循环支持装置一直备受推崇，但与羊膜干细胞疗法联合使用时的情况却知之甚少。
本病例报告了首例采用临时左心室体外装置CentriMag结合远端束带技术和人羊膜干细胞注射治疗一名68岁女性患者严重难治性心源性休克的双重疗法。通过从左心室引流并经远端动脉束带返回右腋动脉，建立了一种微创非体外循环左心室辅助装置，以防止右上肢过度灌注。在左心室心尖、侧壁、下壁和右锁骨下静脉心肌内注射羊膜干细胞。
临时微创非体外循环CentriMag置入与干细胞疗法的联合使用不仅为体外循环和全胸骨正中切开术提供了一种替代方案，而且可能还协同增强了心肌再灌注和再生。
