抢救性球囊肺动脉血管成形术治疗慢性血栓栓塞性肺动脉高压合并应激性心肌病所致难治性心力衰竭
Rescue balloon pulmonary angioplasty for refractory heart failure in chronic thromboembolic pulmonary hypertension complicated with takotsubo cardiomyopathy.
作者信息
Kanezawa Misaki, Naito Takanori, Shimokawahara Hiroto, Ogawa Aiko, Matsubara Hiromi
机构信息
Department of Cardiology, National Hospital Organization Okayama Medical Center, Okayama, Japan.
Department of Clinical Science, National Hospital Organization Okayama Medical Center, Okayama, Japan.
出版信息
J Cardiol Cases. 2023 Jun 14;28(2):79-82. doi: 10.1016/j.jccase.2023.04.004. eCollection 2023 Aug.
UNLABELLED
Balloon pulmonary angioplasty (BPA) seems promising for treating critically ill patients with chronic thromboembolic pulmonary hypertension (CTEPH) because of its less invasive and stepwise nature. However, there are only a few reports on rescue BPA. Herein, we present a case of CTEPH and takotsubo cardiomyopathy in an 82-year-old female. Despite treatment with catecholamines and intra-aortic balloon pumping, low output syndrome due to right heart failure with CTEPH and left heart failure with takotsubo cardiomyopathy did not improve. Therefore, rescue BPA for CTEPH was performed; this immediately improved the patient's hemodynamics.
LEARNING OBJECTIVE
Rescue balloon pulmonary angioplasty (BPA) is an option for critically ill patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) that requires immediate improvement of hemodynamics. BPA strategy initially aimed at partial improvement of pulmonary circulation would be useful in treating CTEPH complicated by refractory right and left heart failure due to coexisting left-sided heart disease.
未标注
球囊肺动脉血管成形术（BPA）因其侵入性较小且具有逐步治疗的特点，对于治疗患有慢性血栓栓塞性肺动脉高压（CTEPH）的重症患者似乎很有前景。然而，关于挽救性BPA的报道很少。在此，我们报告一例82岁女性的CTEPH和应激性心肌病病例。尽管使用了儿茶酚胺和主动脉内球囊反搏治疗，但由CTEPH导致的右心衰竭和应激性心肌病导致的左心衰竭引起的低输出量综合征并未改善。因此，对CTEPH进行了挽救性BPA；这立即改善了患者的血流动力学。
学习目标
挽救性球囊肺动脉血管成形术（BPA）是患有无法手术的慢性血栓栓塞性肺动脉高压（CTEPH）且需要立即改善血流动力学的重症患者的一种选择。最初旨在部分改善肺循环的BPA策略对于治疗因并存左侧心脏病而并发难治性右心和左心衰竭的CTEPH是有用的。
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