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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.

DOI:10.1186/s40981-018-0194-x
PMID:32025942
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6967109/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6651/6967109/09b0bf39a0b8/40981_2018_194_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6651/6967109/32e4b83159a0/40981_2018_194_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6651/6967109/73e14f790fe2/40981_2018_194_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6651/6967109/09b0bf39a0b8/40981_2018_194_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6651/6967109/32e4b83159a0/40981_2018_194_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6651/6967109/73e14f790fe2/40981_2018_194_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6651/6967109/09b0bf39a0b8/40981_2018_194_Fig3_HTML.jpg

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本文引用的文献

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Ventricular Assist Device Implantation in a Patient With Severe Systemic Right Ventricular Failure and Pulmonary Hypertension Secondary to Congenitally Corrected Transposition of Great Arteries.大动脉转位矫正术后继发严重系统性右心室衰竭和肺动脉高压患者的心室辅助装置植入术
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Successful Bridge to Orthotopic Cardiac Transplantation with Implantation of a HeartWare HVAD in Management of Systemic Right Ventricular Failure in a Patient with Transposition of the Great Arteries and Previous Atrial Switch Procedure.
在一名患有大动脉转位且曾接受心房调转术的患者中,通过植入HeartWare HVAD成功实现了向原位心脏移植的过渡,用于治疗系统性右心室衰竭。
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Compartment syndrome of the thigh as a complication of anticoagulant therapy in a patient with a left ventricular assist device (Berlin Heart).大腿骨筋膜室综合征作为左心室辅助装置(柏林心脏)患者抗凝治疗的并发症
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