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成功使用 Impella 5.5 治疗 COVID-19 合并心源性休克。

Successful use of Impella 5.5 to manage cardiogenic shock complicated by COVID-19.

机构信息

Division of Cardiac Surgery, CardioVascular Center, Tufts Medical Center, Boston, Massachusetts, USA.

Division of Anesthesiology and Perioperative Medicine, Division of Cardiac Surgery, CardioVascular Center, Tufts Medical Center, Boston, Massachusetts, USA.

出版信息

J Card Surg. 2021 Dec;36(12):4783-4785. doi: 10.1111/jocs.16038. Epub 2021 Oct 1.

Abstract

BACKGROUND

Acute decompensated heart failure in patients with coronavirus disease 2019 (COVID-19) is becoming increasingly common.

AIMS

In this case report, we describe the successful use of an Impella 5.5 (Abiomed) to treat cardiogenic shock refractory to inotropic therapy.

MATERIALS & METHODS: Transthoracic and transesophageal echocardiography confirmed severely diminished left ventricular ejection fraction and a reverse-transcription polymerase chain reaction test revealed that the patient was COVID-19 positive during his hospital admission.

RESULTS

Following initiation of inotropic therapy, we placed an Impella 5.5 for further cardiac support. The patient's LVEF and cardiac index improved after 21 days on the Impella 5.5 and was maintained following explant.

DISCUSSION & CONCLUSION: The findings reported here demonstrate successful use of an Impella 5.5 to improve native heart function in refractory cardiogenic shock and further indicate its use as an option for those in acute decompensated heart failure who have tested positive for COVID-19 infection.

摘要

背景

新型冠状病毒病 2019(COVID-19)患者的急性失代偿性心力衰竭越来越常见。

目的

在本病例报告中,我们描述了使用 Impella 5.5(Abiomed)成功治疗对正性肌力治疗无反应的心源性休克。

材料与方法

经胸超声心动图和经食管超声心动图证实左心室射血分数严重降低,逆转录聚合酶链反应检测显示患者在住院期间 COVID-19 检测呈阳性。

结果

在开始正性肌力治疗后,我们放置了 Impella 5.5 以提供进一步的心脏支持。在 Impella 5.5 上治疗 21 天后,患者的 LVEF 和心指数得到改善,在取出后得以维持。

讨论与结论

这里报告的结果表明,成功使用 Impella 5.5 改善了难治性心源性休克的原生心脏功能,并进一步表明其可作为 COVID-19 感染检测呈阳性的急性失代偿性心力衰竭患者的一种选择。

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