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梗阻性肥厚型心肌病合并心尖气球样变时的心源性休克：采用体外膜肺氧合（VA-ECMO）和心肌切除术治疗

Cardiogenic Shock in Obstructive Hypertrophic Cardiomyopathy Plus Apical Ballooning: Management With VA-ECMO and Myectomy.

作者信息

Caniato Flavia, Andrei Valentina, Bernardo Pasquale, Agostini Cecilia, Cappelli Francesco, Stefano Pier Luigi, Olivotto Iacopo, Pieroni Maurizio, Bolognese Leonardo, Di Mario Carlo

机构信息

Cardiac Intensive Care Unit, Careggi University Hospital, Florence, Italy.

Cardiac Surgery Unit, Careggi University Hospital, Florence, Italy.

出版信息

JACC Case Rep. 2021 Mar 17;3(3):433-437. doi: 10.1016/j.jaccas.2020.11.029. eCollection 2021 Mar.

DOI:10.1016/j.jaccas.2020.11.029
PMID:34317552
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8311032/
Abstract

A patient with known obstructive hypertrophic cardiomyopathy developed worsening left ventricular outflow tract obstruction, severe mitral regurgitation, and apical ballooning leading to cardiogenic shock, a combination in which treatment of each component could worsen the others. Emergency veno-arterial extracorporeal membrane oxygenation, levosimendan, and noradrenaline transiently restored adequate systemic perfusion and gas exchange. Surgical myectomy offered a more definitive solution. ().

摘要

一名已知患有梗阻性肥厚型心肌病的患者出现左心室流出道梗阻加重、严重二尖瓣反流和心尖气球样变，进而导致心源性休克，这种情况中对每个组成部分的治疗都可能使其他部分恶化。紧急静脉-动脉体外膜肺氧合、左西孟旦和去甲肾上腺素暂时恢复了足够的全身灌注和气体交换。外科心肌切除术提供了更确切的解决方案。（）

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f98a/8311032/a344a04d12f9/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f98a/8311032/1456aa96df4e/fx1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f98a/8311032/5506d123734a/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f98a/8311032/0eeca04bb87f/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f98a/8311032/f8125d58e4cf/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f98a/8311032/a344a04d12f9/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f98a/8311032/1456aa96df4e/fx1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f98a/8311032/5506d123734a/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f98a/8311032/0eeca04bb87f/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f98a/8311032/f8125d58e4cf/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f98a/8311032/a344a04d12f9/gr4.jpg

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Cardiogenic Shock Classification to Predict Mortality in the Cardiac Intensive Care Unit.心原性休克分类预测心脏重症监护病房死亡率。
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Syndrome of Reversible Cardiogenic Shock and Left Ventricular Ballooning in Obstructive Hypertrophic Cardiomyopathy.梗阻性肥厚型心肌病中的可逆性心原性休克和左心室球囊样综合征。
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