Application of ballon atrial septostomy for left heart venting during extracorporeal membrane oxygenation

Chinese Journal of Thoracic and Cardiovaescular Surgery Pub Date : 2020-02-25 DOI:10.3760/CMA.J.ISSN.1001-4497.2020.02.005

Dingyang Li, Gangcheng Zhang, Q. Shen, Yan Liu, Naiwen Cao, Yueting Zhou

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Abstract

Objective To discuss whether balloon atrial septostomy(BAS) can provide safe and effective left ventricular venting for venoarterial extracorporeal membrane oxygenation(V-A ECMO). Methods From March 2017 to January 2019, 9 patients received BAS for left ventricular venting during V-A ECMO treatment in our hospital, including 5 males and 4 females, aged 12-72 years. There were 3 cases of severe myocarditis, 4 cases of low cardiac output after cardiac surgery, and 2 cases of acute myocardial infarction. Basic data, procedure data, outcome and follow-up were recorded. Results BAS were successfully performed in 9 patients. Procedure time on average was 42.2 min. Anterior mediastinal hematoma occurred in 1 case. There were no other procedure-related complications in the rest cases. No pulmonary edema or thrombosis occurred in all 9 cases during ECMO. No closure procedure was performed. Conclusion BAS is a safe and effective method for left ventricular venting. The procedure is conductive to the recovery of patients with severe left heart failure. Key words: Atrial septostomy; Transseptal puncture; Extracorporeal membrane oxygenation; Left ventricular venting

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体外膜氧合中球囊房间隔造口术在左心通气中的应用

目的探讨球囊房间隔造口术(BAS)能否为静脉动脉体外膜氧合(V-A ECMO)提供安全有效的左心室通气。方法2017年3月至2019年1月，我院V-A ECMO治疗期间接受BAS治疗左室通气的患者9例，男5例，女4例，年龄12-72岁。心脏手术后发生严重心肌炎3例，心输出量低4例，急性心肌梗死2例。记录基本资料、手术资料、结果及随访情况。结果9例患者成功行BAS手术。手术时间平均42.2 min，前纵隔血肿1例。其余病例无其他手术相关并发症。9例患者在ECMO过程中均未发生肺水肿和血栓形成。未执行闭合程序。结论BAS是一种安全、有效的左心室通气方法。该手术有助于严重左心衰竭患者的康复。关键词:房间隔造口术;Transseptal穿刺;体外膜氧合;左心室通气

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Chinese Journal of Thoracic and Cardiovaescular Surgery

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