大动脉转位并接受Mustard术后患者因系统性右心室衰竭植入心室辅助装置：一例报告
Implantation of ventricular assist device for systemic right ventricular failure in a patient with transposition of the great arteries and post-Mustard procedure: a case report.
作者信息
Saito Kazutomo, Toyama Hiroaki, Abe Nozomu, Sunouchi Azusa, Ejima Yutaka, Yamauchi Masanori
机构信息
Anesthesiology and Perioperative Medicine, Tohoku University School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
Department of Anesthesiology, Tohoku University Hospital, 1-1 Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan.
出版信息
JA Clin Rep. 2018 Jul 25;4(1):55. doi: 10.1186/s40981-018-0194-x.
BACKGROUND
Ventricular assist device (VAD) is usually attached by an inflow cannula to the apex of the systemic left ventricle (LV), but very few cases with implantation of the VAD in the morphologic right ventricle (RV) have been described.
CASE PRESENTATION
We describe the case of a 41-year-old male who developed severe systemic RV failure related to a Mustard procedure he had as an infant for treatment of TGA. His heart failure was refractory and irreversible, and therefore, he underwent VAD implantation for systemic RV support. Although the patient developed pulmonary congestion on postoperative day (POD) 5, he was discharged on POD 60. He is now looking forward to receiving heart transplantation.
CONCLUSIONS
Placement of a VAD for systemic RV failure could be a life-saving treatment in adult patients with heart failure due to congenital heart disease.
背景
心室辅助装置（VAD）通常通过流入插管连接至体循环左心室（LV）的心尖，但很少有将VAD植入形态学右心室（RV）的病例报道。
病例介绍
我们描述了一名41岁男性患者的病例，他因婴儿期接受Mustard手术治疗大动脉转位（TGA）而出现严重的体循环RV衰竭。他的心力衰竭难治且不可逆，因此，他接受了VAD植入以支持体循环RV。尽管患者在术后第5天（POD 5）出现肺淤血，但他在术后第60天（POD 60）出院。他目前期待接受心脏移植。
结论
对于因先天性心脏病导致心力衰竭的成年患者，植入VAD治疗体循环RV衰竭可能是一种挽救生命的治疗方法。
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