微型化体外循环装置在低射血分数患者心脏介入手术中的应用  

作　　者：孙来 姜建杰[1] 陈英莲[1] 钱林锋[1] 施丽萍[1] 

机构地区：[1]浙江大学医学院附属第一医院,310000

出　　处：《浙江临床医学》2021年第8期1186-1187,共2页Zhejiang Clinical Medical Journal

基　　金：浙江省自然科学基金资助项目(LQ20H020003)。

摘　　要：目的探讨微型化体外循环装置(MECC)在低射血分数危重症患者介入手术中的应用价值。方法回顾性分析5例应用MECC辅助行心脏介入手术的低射血分数危重症患者的临床资料,包括患者的基本情况、辅助原因、辅助时间、并发症及预后等。结果5例患者的术前左心室射血分数(LVEF)为(30%±5%),心功能Ⅳ级,在MECC辅助下顺利完成经股TAVR手术2例、PCI术3例,辅助时间45 min~123 min,术中血流动力学平稳,未出现室颤、心脏停跳等严重并发症,手术切口未见明显渗血。所有患者均顺利停机并撤除MECC,术后胸闷、心力衰竭的症状得到控制,均康复出院。术后随访,经胸心脏超声提示心功能改善,LVEF为(50%±5%)。结论MECC辅助在低射血分数危重症患者行心脏介入手术时能够提供有效的循环支持,需要短期辅助循环的患者行介入手术,MECC比ECMO更具有经济效益。Objective To explore the application value of miniature extracorporeal circulation device(MECC)in interventional surgery for critically ill patients with low ejection fraction.Methods A retrospective analysis of the clinical data of 5 critically ill patients with low ejection fraction who underwent MECC-assisted cardiac interventional surgery,including the basic conditions of the patients,auxiliary reasons,auxiliary time,complications and prognosis,etc.Results 5 patients with preoperative left ventricular ejection fraction(LVEF)as(30%±5%),cardiac function grade Ⅳ(NYHA classification).With the assistance of MECC,2 cases of femoral TAVR and 3 cases of PCI were successfully completed.The auxiliary time was 45~123min.The intraoperative hemodynamics was stable,and no serious complications such as ventricular fibrillation and cardiac arrest occurred.MECC was successfully stopped and removed in all patients.Postoperative chest tightness and heart failure symptoms were controlled,and all patients recovered and were discharged from the hospital.Postoperative follow-up showed improvement in cardiac function via thoracic echocardiography,with LVEF(50%±5%).Conclusion MECC assistance can provide effective circulatory support for patients with low ejection firaction undergoing cardiac interventions.MECC is more cost-efiective than ECMO for short-term circulatory assistance during critical cardiac interventions.

关 键 词：微型化体外循环装置 低射血分数 心脏介入手术 

分 类 号：R54[医药卫生—心血管疾病]