Kuwano Akito, Fumoto Hideyuki, Uchino Motonori, Koga Kiyokazu, Nakayama Yoshihiro
Department of Cardiovascular Surgery, Osumikanoya Hospital, Kanoya, Japan.
Kyobu Geka. 2022 Feb;75(2):142-145.
Postoperative hemodynamic support with an Impella 5.0 was effective in an obese man who underwent coronary artery bypass grafting (CABG) for ischemic heart disease and cardiogenic shock. A 43-year-old obese man presented to our hospital complaining severe chest pain. Coronary angiography revealed acute coronary syndrome due to severe triple-vessel disease, and the patient fell into a state of shock, which required veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support. The patient subsequently underwent CABG, but he was unable to be separated from VA-ECMO. Impella 5.0 was introduced through right axillary artery on the next day. VA-ECMO was converted to veno-venous (VV)-ECMO on the 3rd postoperative day to enable respiratory rehabilitation in a sitting posi-tion;his respiratory status gradually improved. VV-ECMO and the Impella 5.0 were discontinued on the 6th and 7th postoperative days, respectively. He was eventually transferred to nearby facility for further rehabilitation three months later. As of two years, his cardiac function has improved and he is doing well at home.
对于一名因缺血性心脏病和心源性休克接受冠状动脉旁路移植术（CABG）的肥胖男性，使用Impella 5.0进行术后血流动力学支持是有效的。一名43岁的肥胖男性因严重胸痛前来我院就诊。冠状动脉造影显示因严重三支血管病变导致急性冠状动脉综合征，患者陷入休克状态，需要静脉-动脉体外膜肺氧合（VA-ECMO）支持。患者随后接受了CABG，但无法脱离VA-ECMO。次日通过右腋动脉置入Impella 5.0。术后第3天，VA-ECMO转换为静脉-静脉（VV）-ECMO，以便患者能够以坐姿进行呼吸康复；其呼吸状况逐渐改善。VV-ECMO和Impella 5.0分别在术后第6天和第7天停用。三个月后，他最终被转至附近机构进行进一步康复治疗。截至两年时，他的心脏功能已改善，在家中情况良好。
