Ko W J, Chen Y S, Chou N K, Wang S S, Chu S H
Department of Surgery, National Taiwan University Hospital, Taipei, ROC.
J Formos Med Assoc. 1997 Feb;96(2):83-90.
Mechanical circulatory support is occasionally needed in the perioperative period of heart transplantation. Between February and May 1995, three recipients of cardiac transplant at the National Taiwan University Hospital required the use of extracorporeal membrane oxygenation (ECMO) for temporary mechanical circulatory support in the perioperative period of heart transplantation. All three patients received ECMO through the percutaneous femoral veno-arterial route. The ECMO device has a heparin-bound Carmeda Bioactive surface and centrifugal pump. Patient 1 needed ECMO for treatment of a postoperative pulmonary hypertensive crisis. Patient 2 needed ECMO for early cardiac allograft failure, possibly due to ischemia. Patient 3 needed ECMO as a bridge to his first heart transplant after acute myocardial infarction complicated with cardiogenic shock, and again as a bridge to retransplantation because of acute failure of the first cardiac transplant and finally for a temporary circulatory support during rescue treatment for acute vascular rejection of the second cardiac transplant. All three patients were successfully treated with ECMO without major complications. In conclusion, ECMO provides excellent mechanical circulatory support for some situations in the perioperative period of heart transplantation.
在心脏移植的围手术期偶尔需要机械循环支持。1995年2月至5月间，国立台湾大学医院的三名心脏移植受者在心脏移植围手术期需要使用体外膜肺氧合（ECMO）进行临时机械循环支持。所有三名患者均通过经皮股静脉 - 动脉途径接受ECMO治疗。该ECMO设备具有肝素结合的卡美达生物活性表面和离心泵。患者1需要ECMO治疗术后肺动脉高压危象。患者2需要ECMO治疗早期心脏移植失败，可能是由于缺血。患者3在急性心肌梗死并发心源性休克后需要ECMO作为首次心脏移植的桥梁，又因首次心脏移植急性失败而再次作为再次移植的桥梁，最后在第二次心脏移植急性血管排斥反应的抢救治疗期间作为临时循环支持。所有三名患者均成功接受ECMO治疗，无重大并发症。总之，ECMO为心脏移植围手术期的某些情况提供了出色的机械循环支持。
