Perko M J, Sander-Jensen K, Dehnke C, Pettersson G
Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen, Denmark.
Artif Organs. 1995 Jul;19(7):777-81. doi: 10.1111/j.1525-1594.1995.tb02424.x.
Clinical outcome and hemodynamic effects of unilateral mechanical ventricular support (UMVS) were evaluated in 19 patients with postcardiotomy heart failure refractory to conventional treatment. Adequate circulation with UMVS was maintained in about 75% of the patients. UMVS initiated circulatory stabilization in 5 of 6 patients with biventricular failure, in 2 of 3 patients with right ventricular failure, and in 7 of 10 patients with left ventricular failure. Eight (42%) patients were successfully weaned from UMVS and discharged from hospital. Six (32%) patients died despite a prolonged, stabilized circulation by UMVS. In 5 (26%) patients, the UMVS could not secure stable circulation. Application of the left UMVS induced increases in cardiac output and systemic blood pressure and a decrease in left atrial pressure without changes in pre- and afterload of the right ventricle. It is concluded that application of UMVS may induce adequate circulation in patients with postcardiotomy heart failure refractory to treatment with inotropes and intraaortic counterpulsation. The outcome of UMVS in left, right, and biventricular failure is acceptable. Thus, this treatment may be recommended for patients with postcardiotomy heart failure.
对19例心脏手术后心力衰竭且常规治疗无效的患者进行了单侧机械心室辅助（UMVS）的临床结局和血流动力学效应评估。约75%的患者通过UMVS维持了充足的循环。UMVS使6例双心室衰竭患者中的5例、3例右心室衰竭患者中的2例以及10例左心室衰竭患者中的7例实现了循环稳定。8例（42%）患者成功脱离UMVS并出院。6例（32%）患者尽管通过UMVS实现了长时间的循环稳定，但仍死亡。5例（26%）患者中，UMVS未能确保稳定的循环。应用左UMVS可使心输出量和体循环血压升高，左心房压力降低，而右心室的前负荷和后负荷无变化。得出的结论是，对于心脏手术后心力衰竭且对强心剂和主动脉内反搏治疗无效的患者，应用UMVS可能诱导充足的循环。UMVS在左心室、右心室和双心室衰竭中的结局是可以接受的。因此，对于心脏手术后心力衰竭患者，可推荐这种治疗方法。
