Hara Kantaro, Miyamoto Hikaru, Furukawa Nao, Kimura Takuya, Soeda Satsuki, Okabe Kazunori
Department of Thoracic Surgery, Bell-Land General Hospital, Sakai, Japan.
Department of Cardiology, Asakayama General Hospital, Sakai, Japan.
J Surg Case Rep. 2023 May 27;2023(5):rjad258. doi: 10.1093/jscr/rjad258. eCollection 2023 May.
Postoperative hemodynamic support with an Impella 5.0 was effective in a man who underwent lung lobectomy for lung cancer and cardiogenic shock. A 75-year-old man presented to hospital with an abnormal chest shadow on radiography. After thorough examination, the patient was diagnosed with lung cancer, and left lower lobectomy was performed. On the 2nd postoperative day, the patient experienced cardiac arrest because of a sudden drop in saturation of percutaneous oxygen. After a third defibrillation, his heartbeat resumed, and he was intubated and placed on a ventilator. Coronary angiography revealed acute coronary syndrome and the patient fell into a state of shock, which required venoarterial extracorporeal membrane oxygenation (VA-ECMO) support. Nevertheless, the circulatory dynamics are unstable, and Impella 5.0 was introduced. VA-ECMO and the Impella 5.0 were discontinued on the 6th and 8th postoperative days, respectively. The patient was eventually transferred to a nearby facility for further rehabilitation 109 days later.
一名因肺癌接受肺叶切除术并发生心源性休克的男性患者,使用Impella 5.0进行术后血流动力学支持取得了良好效果。一名75岁男性因胸部X光片显示异常阴影入院。经过全面检查,患者被诊断为肺癌,并接受了左下肺叶切除术。术后第2天,患者因经皮血氧饱和度突然下降发生心脏骤停。第三次除颤后,患者心跳恢复,随后进行气管插管并使用呼吸机。冠状动脉造影显示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。然而,循环动力学仍不稳定,于是引入了Impella 5.0。VA-ECMO和Impella 5.0分别在术后第6天和第8天停用。最终,患者在109天后被转至附近机构进行进一步康复治疗。