Hachida M, Saito S, Kihara S, Kitamura M, Koyanagi H
Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical College, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1997 Aug;45(8):1203-7.
The Novacor left ventricular assist device has been widely applied as a bridge to heart transplantation. The patient, a 29-year-old, male had severe left ventricular failure due to dilated cardiomyopathy. The heart failure had progressively worsened and showed severely reduced wall motion of the left ventricle with fraction shortening of 0.03. His cardiac catheterization data with 7 r of dopamine infusion was as follows; RA(12), RV46/9EDP(12), PA(w)(31), cardiac Index 1.73 l/min/cm2. Novacor implantation was performed on March 11th, 1996. After the implantation the patient was extubated on day 3 and recovered rapidly. No complications, such as bleeding or thromboembolic episodes were seen. The patient was flown to the USA for cardiac transplantation on 24th, September, 1996. During the 11-hour flight from Narita to Los Angeles, he experienced no adverse effects. The patient underwent a successful cardiac transplant at UCLA Medical Center. His post-operative course was uneventful. We believe that either chronic circulatory support or the bridge to transplant using Novacor LVAS will be a significant breakthrough for the treatment of Japanese patients with severely deteriorated cardiomyopathy.
诺瓦科尔左心室辅助装置已被广泛用作心脏移植的桥梁。该患者为一名29岁男性，因扩张型心肌病导致严重左心室衰竭。心力衰竭逐渐恶化，左心室壁运动严重减弱，缩短分数为0.03。他在静脉输注7μg多巴胺时的心脏导管检查数据如下：右心房压（12），右心室压46/9（舒张末期压12），肺动脉压（收缩压）（31），心脏指数1.73升/分钟/平方厘米。1996年3月11日进行了诺瓦科尔植入手术。植入后第3天患者拔除气管插管，并迅速康复。未出现出血或血栓栓塞等并发症。1996年9月24日，该患者被空运至美国进行心脏移植。在从成田飞往洛杉矶的11小时飞行过程中，他未出现不良反应。患者在加州大学洛杉矶分校医疗中心成功接受了心脏移植手术。其术后过程顺利。我们认为，无论是长期循环支持还是使用诺瓦科尔左心室辅助装置作为移植桥梁，都将是治疗日本重症心肌病患者的重大突破。
