Oz M C, Slater J P, Edwards N, Dickstein M L, Beck J R, Spotnitz H M, Levin H R
Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, N.Y., USA.
J Heart Lung Transplant. 1995 Jan-Feb;14(1 Pt 1):172-6.
Right-sided circulatory failure is a major cause of morbidity in heart transplant and ventricular assist device recipients.
Several systems for managing right-sided circulatory failure with use of a right-to-left shunt without need for an oxygenator or systemic heparinization were designed and used clinically.
A right-to-left shunt was successfully used to treat severe right-sided circulatory failure in both a transplant and a left ventricular assist device recipient.
If constructed between the femoral vein and artery, such a shunt could (1) be easily inserted and removed, (2) selectively infuse the lower extremities with desaturated blood while maintaining cerebral and cardiac perfusion with saturated blood, (3) selectively reduce the risk of paradoxical emboli to the head and heart, and (4) provide a known and adjustable degree of shunting depending on the condition of the patient, a major advantage of this system compared with creation of an atrial septal defect.
右侧循环衰竭是心脏移植和心室辅助装置接受者发病的主要原因。
设计了几种利用右向左分流来管理右侧循环衰竭的系统，无需使用氧合器或全身肝素化，并在临床上得到应用。
右向左分流成功用于治疗一名移植患者和一名左心室辅助装置接受者的严重右侧循环衰竭。
如果在股静脉和动脉之间构建这样的分流，它可以（1）轻松插入和移除，（2）在向大脑和心脏输送饱和血液以维持灌注的同时，选择性地向下肢输送未饱和血液，（3）选择性降低头部和心脏反常栓塞的风险，（4）根据患者情况提供已知且可调节的分流程度，与制造房间隔缺损相比，这是该系统的一个主要优势。
