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心包切除术治疗缩窄性心包炎伴或不伴体外循环。

Pericardiectomy for Constrictive Pericarditis with or without Cardiopulmonary Bypass.

机构信息

Department of Cardiothoracic Surgery, The People's Hospital of Guangxi Zhuang Autonomous Region, and Guangxi Academy of Medical Sciences, Nanning, Guangxi, People's Republic of China.

出版信息

Vasc Health Risk Manag. 2024 Feb 8;20:39-46. doi: 10.2147/VHRM.S439292. eCollection 2024.

Abstract

AIM

We aim to access the effect of pericardiectomy for constrictive pericarditis with or without cardiopulmonary bypass.

METHODS

This was a review of pericardiectomy for constrictive pericarditis.

RESULTS

Cardiopulmonary bypass is actually an important maneuver to attain complete relief of the constriction. The short additional time of cardiopulmonary bypass during the procedure has very little effect on the risk of morbidity of the main operation.

CONCLUSION

Incomplete pericardiectomy perhaps was the cause of postoperative remnant constriction and high diastolic filling pressure leading to multiorgan failure. Complete pericardiectomy (removal of phrenic-to-phrenic and the postero-lateral and inferior wall pericardial thickening) using cardiopulmonary bypass should be the routine for total relief of the constriction of the heart.

摘要

目的

评估行或不行体外循环下心包切除术治疗缩窄性心包炎的效果。

方法

本研究回顾了行心包切除术治疗缩窄性心包炎的病例。

结果

体外循环实际上是解除心包缩窄的重要手段。手术中体外循环的附加时间很短,对主要手术的发病率风险几乎没有影响。

结论

心包切除不彻底可能是术后残余缩窄和舒张末期充盈压升高导致多器官衰竭的原因。使用体外循环行彻底心包切除术(切除膈神经至膈神经和心后外侧及下壁心包增厚)应作为彻底解除心脏缩窄的常规方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fda/10860389/70a5f04112fe/VHRM-20-39-g0001.jpg

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