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[二尖瓣重建术后动态左心室内梗阻]

[Dynamic left intraventricular obstruction after reconstructive mitral valve surgery].

作者信息

Trabold F, Wernet A, Olivier P, Sirieix D, Meimoun P, Baron J F

机构信息

Département d'anesthésie-réanimation, hôpital Broussais, Paris, France.

出版信息

Ann Fr Anesth Reanim. 1998;17(9):1152-5. doi: 10.1016/s0750-7658(00)80011-8.

Abstract

A 71-years-old patient, undergoing mitral valve repair for degenerative valvulopathy and correction of pectus excavatus experienced a cardiogenic shock after weaning from cardiopulmonary bypass. The shock occurred after calcium chloride administration and was unresponsive to inotropic drugs. Transoesophageal echocardiography showed left ventricular outflow tract obstruction due to systolic anterior motion (SAM) of the mitral valve. Discontinuation of inotropic drugs and volume expansion restored the haemodynamic status. By its haemodynamic effects calcium chloride can cause left ventricular outflow tract obstruction, recognized by transoesophageal echocardiography.

摘要

一名71岁患者因退行性瓣膜病接受二尖瓣修复术及漏斗胸矫正术,在体外循环撤机后发生心源性休克。休克发生在氯化钙给药后,对强心药物无反应。经食管超声心动图显示二尖瓣收缩期前向运动(SAM)导致左心室流出道梗阻。停用强心药物和扩容后恢复了血流动力学状态。氯化钙因其血流动力学效应可导致左心室流出道梗阻,经食管超声心动图可识别。

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