耳前腔隔膜术对左心室功能的影响 儿科扩大心肌病需要ECMO
Dean S Karahalios1, Gilda Kadiu2, Ahmad Farooqi3
1Department of Pediatrics, Division of Pediatric Cardiology, Northwestern University Ann and Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Chicago, IL, 60611, USA. dkarahalios@luriechildrens.org.
Pediatric cardiology
|August 9, 2024
概括
在ECMO治疗的儿科患者中,气球心房隔膜术 (BAS) 暂时恶化左心室 (LV) 功能,以减少喷射分数和分数缩短为标志. 然而,LV功能在一周内恢复,手术并发症率低.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 心血管外科心血管外科
- 关键护理医学 关键护理医学
背景情况:
- 气球心房间隔膜整形术 (BAS) 用于缓解左心室 (LV) 高血压在接受体外膜氧化 (ECMO) 的儿科患者.
- 在这种脆弱人群中,BAS对LV功能的急性影响,特别是通过心声回声学评估的急性影响,仍然不完全理解.
研究的目的:
- 追溯分析巴斯在儿科患者扩张性心肌病症需要ECMO的儿科患者的LV尺寸和功能上的急性影响.
- 为了评估临床结果,手术并发症和与此队列中BAS相关的不良事件.
主要方法:
- 对13名患有扩张性心肌病的儿科患者 (0-18岁) 进行了回顾性分析,他们接受了ECMO.BAS.
- 在BAS之前和之后对LV维度 (LVIDs),LV末缩后壁厚度 (LVPWs),分数缩短 (FS) 和射出分数 (EF) 的心声评估.
- 还评估了心脏输出,手术并发症和急性损伤的临床标志物.
主要成果:
- 在BAS后,没有观察到心脏输出临床标志物的显著变化.
- 在BAS之后,立即注意到LV末缩直径,后壁厚度,分数缩短和射出分数的短暂恶化 (p <0.05对所有).
- 在大约一周内,LV功能参数得到改善,LV全球纵向菌株没有显著变化,周围手术并发症率低.
结论:
- 在ECMO治疗中患有扩张性心肌病的儿科患者的气球心房隔膜术与手术和临床不良事件的发病率较低有关.
- 在BAS后观察到的LV缩功能急性下降表明负载条件发生了变化,这似乎在一周内可逆.
- 在这个患者群体中,心声监测对于评估在BAS之后LV中的过渡性功能变化至关重要.
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