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体外膜肺氧合用于治疗肝移植术后急性心肌病:一例报告

Use of extracorporeal membrane oxygenation for treating acute cardiomyopathy after liver transplantation: a case report.

作者信息

Biondi Rodrigo Santos, Barzilai Vitor Salvatore, Watanabe André Luis Conde, Ferreira Gustavo de Sousa Arantes, Atik Fernando Antibas

机构信息

Unidade de Terapia Intensiva Cirúrgica, Instituto de Cardiologia do Distrito Federal - Brasília (DF), Brasil.

Unidade de Transplante Hepático, Instituto de Cardiologia do Distrito Federal - Brasília (DF), Brasil.

出版信息

Rev Bras Ter Intensiva. 2018 Apr-Jun;30(2):233-236. doi: 10.5935/0103-507X.20180029.

Abstract

We report the case of a female patient, 58 years of age, without known heart disease, who underwent liver transplantation without complications. On the second postoperative day, the patient developed cardiogenic shock secondary to stress-induced cardiomyopathy (Takotsubo-like syndrome). The patient was successfully managed with veno-arterial peripheral extracorporeal membrane oxygenation for 6 days, with complete recovery of cardiac function and of the hepatic graft. Coronary syndrome and acute myocarditis were excluded as the causes of the shock. The use of extracorporeal membrane oxygenation in this scenario is possible and safe, considering its specialized protocols and treatment.

摘要

我们报告了一例58岁的女性患者,她没有已知的心脏病史,接受了肝脏移植且未出现并发症。术后第二天,该患者因应激性心肌病(类Takotsubo综合征)继发心源性休克。患者通过静脉-动脉外周体外膜肺氧合成功治疗了6天,心脏功能和肝脏移植均完全恢复。排除了冠状动脉综合征和急性心肌炎作为休克的病因。考虑到其专门的方案和治疗方法,在这种情况下使用体外膜肺氧合是可行且安全的。

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引用本文的文献

本文引用的文献

1
Cirrhotic cardiomyopathy in the pre- and post-liver transplantation phase.
J Cardiol. 2016 Feb;67(2):125-30. doi: 10.1016/j.jjcc.2015.04.016. Epub 2015 Jun 11.
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Pseudo-acute myocardial infarction due to transient apical ventricular dysfunction syndrome (Takotsubo syndrome).
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Stress-induced cardiomyopathy (takotsubo cardiomyopathy) after liver transplantation-report of two cases.
Transplant Proc. 2012 Oct;44(8):2497-500. doi: 10.1016/j.transproceed.2012.07.037.

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