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预防性Impella 5.5插入,以减少高风险心脏手术中的手术风险:一个病例报告

Chidiebere Peter Echieh¹, Alex Ryan², Abel Cherian²

¹Division of Cardiothoracic Surgery, Department of Surgery, University of Arizona, United States of America.

International journal of surgery case reports

|July 4, 2024

概括

高风险的心脏手术患者可以从早期的Impella 5.5植入中受益. 这种机械循环支持装置可以降低操作风险,改善复杂程序的结果.

科学领域:

心血管外科心血管外科
机械循环支持机械循环支持
心脏麻醉心脏麻醉

背景情况:

胸部外科医生协会 (STS) 风险评分识别了患有心脏手术禁止性手术风险的患者 (STS评分>8%).
在高风险患者中尽量减少术后血动力学不稳定仍然是一个挑战.
在血液动力学妥协之前,越来越多地考虑机械循环支持 (MCS).

研究的目的:

评估Impella 5.5在接受复杂心脏手术的高风险患者中的使用.
评估同时植入Impella 5.5的潜力,以减轻外科手术期间的风险.

主要方法:

一名75岁的男性患有多种并发症,STS得分高 (>9.8%),接受了重复冠状动脉旁路移植和大动脉/心心门置换.
在手术过程中同时植入Impella 5.5装置.
进行了术后恢复和血液动力学参数的监测.

主要成果:

患者经历了良好的康复,尽管患有术后心房动.
伊佩拉5.5提供了足够的内源性输液和LV卸载.
观察到压力器支的需求减少.

结论:

同时在高风险的心脏手术候选人中放置Impella 5.5可能会降低手术风险.
该设备有效地卸载左心室并提供前向流动,这对于管理心脏性休克至关重要.
将像Impella 5.5这样的MCS集成到手术规划中,可以潜在地减轻外科期间的风险.

关键词:

同时植入Impella 5.5 的同时植入.高风险的心脏手术是高风险的心脏手术.伊姆佩拉 5.5 在线播放机械循环支持机械循环支持在心脏切除术后,心脏会受到冲击.

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