Yamashita T, Kozawa S, Okada M, Ohta T, Ataka K, Kitade T
Department of Surgery, Kobe University School of Medicine, Japan.
Kyobu Geka. 1994 Apr;47(4):283-7.
A case of acute aortic dissection (Stanford Type A) with severe aortic regurgitation successfully treated by postoperative ECMO was reported. The patient was 41-year-old man in shock condition and was transferred to Kobe University Hospital. Chest CT scan and echocardiogram revealed acute aortic dissection with severe aortic regurgitation. An emergent operation by Collins' method and resuspension of aortic valve were carefully performed. Consequent ECMO was necessitated because of postoperative left ventricular and respiratory failure. Thereby, ECMO using heparin-coated CBAS-MAXIMA membrane oxygenator, centrifugal pump, and tubes was established by arterial cannulation via the anastomotic site of the ascending aorta to prevent the obstruction of the aortic true lumen by the false lumen which may be enlarged by retrograde perfusion via the femoral artery. Left ventricular function and pulmonary function were improved after 6 hours and 20 minutes, thus ECMO was successfully weaned without any complications.
报道了一例急性主动脉夹层（斯坦福A型）伴严重主动脉瓣关闭不全经术后体外膜肺氧合（ECMO）成功治疗的病例。患者为一名41岁处于休克状态的男性，被转送至神户大学医院。胸部CT扫描和超声心动图显示为急性主动脉夹层伴严重主动脉瓣关闭不全。通过柯林斯法进行了紧急手术，并仔细地重新悬吊了主动脉瓣。术后因左心室和呼吸功能衰竭而需要进行ECMO治疗。因此，通过经升主动脉吻合部位进行动脉插管，使用肝素涂层的CBAS-MAXIMA膜式氧合器、离心泵和管道建立了ECMO，以防止因假腔通过股动脉逆行灌注而扩大，进而阻塞主动脉真腔。6小时20分钟后左心室功能和肺功能得到改善，因此ECMO成功撤机，未出现任何并发症。
