Higuchi Kazuhiko, Suzuki Hirotoshi, Miyairi Tsuyoshi
Department of Cardiovascular Surgery, Kashima Heart Clinic, Kamisu, Japan.
Kyobu Geka. 2018 Nov;71(12):1000-1003.
A severely calcified ascending aorta increases the risk of perioperative cerebral damage in cardiac surgery. Conventional aortic valve replacement using an external aortic cross clamp may be dangerous in patients with this morbidity. We used an intra-aortic balloon occlusion catheter(IABOC)to minimize risks of aortic valve replacement(AVR) in an 81-year-old man with severe aortic stenosis combined with a severely calcified aorta. IABOC was introduced to the ascending aorta via the right femoral artery by esophageal echocardiography. The precise site of the inflated balloon was confirmed by the pressure of the right radial artery and was secured by 2 tourniquets around the ascending aorta. The postoperative course was uneventful. Our technique can contribute to prevention of embolic complications in some patients with a severely calcified ascending aorta.
严重钙化的升主动脉会增加心脏手术围手术期脑损伤的风险。对于患有这种病症的患者,使用外部主动脉交叉夹进行传统主动脉瓣置换可能具有危险性。我们使用主动脉内球囊阻塞导管(IABOC),以将一名患有严重主动脉瓣狭窄合并严重钙化主动脉的81岁男性患者进行主动脉瓣置换(AVR)的风险降至最低。通过食管超声心动图将IABOC经右股动脉插入升主动脉。通过右桡动脉压力确认膨胀球囊的精确位置,并通过围绕升主动脉的2条止血带固定。术后过程顺利。我们的技术有助于预防一些严重钙化升主动脉患者的栓塞并发症。