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[扩张型心肌病伴严重左心室功能障碍急重症患者左心室辅助系统撤机经验:一例报告]

[Experience of weaning from left ventricular assist system in an acutely-ill patient with dilated cardiomyopathy and severe left ventricular dysfunction: a case report].

作者信息

Fujimura M, Komamura K, Sasaki T, Nakatani S, Yasumura Y, Yamagishi M, Miyatake K, Tsukada T, Sasako Y, Nakatani T

机构信息

Division of Cardiology, National Cardiovascular Center, Osaka.

出版信息

J Cardiol. 1998 Jan;31(1):31-6.

PMID:9488949
Abstract

A 21-year-old man with dilated cardiomyopathy recovered from terminal heart failure with the long-term use of the left ventricular assist system (LVAS). His heart failure was refractory to maximum medical therapy including beta-blockade and intravenous catecholamines. Application of LVAS restored renal and hepatic function and even cardiac function. Left ventricular size decreased from 79 to 57 mm, and cardiac index increased from 1.6 to 2.2 l/min/m2. After 6 weeks of LVAS application, he could walk in the ward and could start exercise on a bicycle ergometer 3 months after. Ninety-five days after implantation, the LVAS could be removed. His general condition remained good and stable for more than a year after the removal of the LVAS. Timely application of LVAS seems to be one of the most important factors for successful circulatory support. Detailed criteria for LVAS application are not established yet.

摘要

一名21岁的扩张型心肌病男性患者,通过长期使用左心室辅助系统(LVAS)从终末期心力衰竭中康复。他的心力衰竭对包括β受体阻滞剂和静脉注射儿茶酚胺在内的最大程度药物治疗均无效。LVAS的应用恢复了肾脏和肝脏功能,甚至心脏功能也得以恢复。左心室大小从79毫米降至57毫米,心脏指数从1.6升/分钟/平方米增加到2.2升/分钟/平方米。应用LVAS 6周后,他能够在病房内行走,并在3个月后开始在自行车测力计上进行锻炼。植入LVAS 95天后,可以将其移除。移除LVAS后一年多来,他的一般状况保持良好且稳定。及时应用LVAS似乎是成功进行循环支持的最重要因素之一。目前尚未确立LVAS应用的详细标准。

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