Matsumoto Yorihiko, Yamazaki Masataka, Tanabe Yuriko, Harada Daiki, Takahashi Tatsuo, Kimura Naritaka, Ito Tsutomu, Shimizu Hideyuki
Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan.
Ann Thorac Surg Short Rep. 2024 Oct 30;3(2):495-498. doi: 10.1016/j.atssr.2024.10.012. eCollection 2025 Jun.
In cardiogenic shock with severely compromised left ventricle (LV) function, systemic perfusion and LV unloading are crucial to reduce pulmonary afterload and thrombus risk. Peripheral extracorporeal life support (ECLS) is commonly used, but central ECLS with LV venting is often required when the peripheral support is insufficient. We propose the "LV apex chimney graft technique," a novel and straightforward method for direct LV cannulation via median sternotomy or left anterior thoracotomy. This approach allows for secure cannula fixation and effective LV venting in the central ECLS, minimizing bleeding risk and offering a reproducible technique.
在左心室（LV）功能严重受损的心源性休克中，全身灌注和左心室减负对于降低肺后负荷和血栓风险至关重要。通常使用外周体外生命支持（ECLS），但当外周支持不足时，常需要带有左心室排气的中心ECLS。我们提出了“左心室尖部烟囱移植技术”，这是一种通过正中胸骨切开术或左前开胸术直接进行左心室插管的新颖且简单的方法。这种方法允许在中心ECLS中安全地固定插管并有效地进行左心室排气，将出血风险降至最低，并提供一种可重复的技术。
