Department of Medicine, Division of Cardiovascular Medicine.
Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
J Card Fail. 2021 Apr;27(4):501-504. doi: 10.1016/j.cardfail.2020.12.014. Epub 2021 Jan 16.
This study describes the authors' experience with a limited balloon atrial septostomy technique, using a median balloon size of 15 mm, as a left ventricular (LV) unloading strategy in venoarterial extracorporeal membrane oxygenation (VA-ECMO). There has been increasing use of VA-ECMO in cardiogenic shock. Although LV unloading strategies have been suggested to improve outcomes, it is unclear which strategy is optimal.
We performed a retrospective study of patients who underwent a limited balloon atrial septostomy for LV unloading in peripheral VA-ECMO at a single center. The goal of this study was to define the procedural outcomes and clinical characteristics of these patients. Of the 12 patients identified, none had complications related to the procedure. There was a significant decrease in the mean left atrial pressure and the majority of patients had radiologic improvement in pulmonary vascular congestion. Of the 12 patients, 58.3% survived to discharge.
Limited BAS is an elegant and safe method for unloading the LV in peripheral VA-ECMO.
本研究描述了作者在经外周静脉-动脉体外膜肺氧合（VA-ECMO）中使用 15mm 中号球囊进行有限球囊房间隔造口术作为左心室（LV）卸载策略的经验。在心肌梗死导致的心源性休克中，VA-ECMO 的应用越来越多。虽然已经提出 LV 卸载策略可以改善预后，但哪种策略最有效尚不清楚。
我们对在单个中心接受经外周 VA-ECMO 行 LV 卸载的有限球囊房间隔造口术的患者进行了回顾性研究。本研究的目的是确定这些患者的程序结局和临床特征。在确定的 12 名患者中，无 1 例与该手术相关的并发症。左心房压力的均值显著降低，大多数患者的肺血管充血的影像学改善。12 名患者中，58.3%的患者存活至出院。
有限的 BAS 是经外周 VA-ECMO 中卸载 LV 的一种优雅且安全的方法。
