Christ G, Zehetgruber M, Mundigler G, Coraim F, Laufer G, Wolner E, Maurer G, Siostrzonek P
Department of Cardiology, University of Vienna, Austria.
Intensive Care Med. 1997 Mar;23(3):297-300. doi: 10.1007/s001340050331.
To demonstrate that emergency aortic valve replacement can be successfully performed in patients with critical aortic stenosis and reduced left ventricular function even in cardiogenic shock with associated severe multiple organ failure.
Retrospective, consecutive case series.
Multidisciplinary intensive care unit of a tertiary care university hospital.
Five patients admitted to the intensive care unit with critical aortic stenosis (aortic valve area 0.56 +/- 0.13 cm2) and greatly reduced left ventricular ejection fraction (20 +/- 3%) in prolonged cardiogenic shock and associated multiple organ failure (Multiple organ failure score 6.8 +/- 0.5; Acute Physiology, Age, and Chronic Health Evaluation III score 91 +/- 27).
Emergency aortic valve replacement.
All patients survived with full recovery of organ function. At follow-up (18 +/- 10 months) all patients were in New York Heart Association functional class I or II with improvement of left ventricular ejection fraction to 48 +/- 25%.
This excellent outcome suggests that emergency aortic valve replacement should be strongly considered in patients with critical aortic stenosis even in cardiogenic shock and multiple organ failure.
证明即使在伴有严重多器官功能衰竭的心源性休克患者中，对于重度主动脉瓣狭窄且左心室功能降低的患者，急诊主动脉瓣置换术也可成功实施。
回顾性连续病例系列。
一所三级大学医院的多学科重症监护病房。
五名入住重症监护病房的患者，患有重度主动脉瓣狭窄（主动脉瓣面积0.56±0.13平方厘米），在长期心源性休克及相关多器官功能衰竭中左心室射血分数大幅降低（20±3%）（多器官功能衰竭评分6.8±0.5；急性生理学与慢性健康状况评分系统III评分91±27）。
急诊主动脉瓣置换术。
所有患者均存活，器官功能完全恢复。随访（18±10个月）时，所有患者纽约心脏协会心功能分级为I级或II级，左心室射血分数提高至48±25%。
这一良好结果表明，即使在伴有心源性休克和多器官功能衰竭的重度主动脉瓣狭窄患者中，也应强烈考虑急诊主动脉瓣置换术。
