体外膜氧合中球囊房间隔造口术在左心通气中的应用

Dingyang Li, Gangcheng Zhang, Q. Shen, Yan Liu, Naiwen Cao, Yueting Zhou
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引用次数: 0

摘要

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