在急性心肌梗塞后心室隔膜破裂 - - Va-Ecmo能给我们额外的时间吗?
Sara Teixeira1, Inês Mendonça1, Rita Ferreira1
1Intensive Care Medicine Department, Centro Hospitalar Universitário de São João, Porto, Portugal.
概括
心肌梗塞 (MI) 后的静脉隔膜破裂 (VSR) 是一种罕见的并发症. 通过机械循环支持 (MCS) 支持的延迟手术修复可能会改善结果,可能成为心脏移植的桥梁.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 关键护理医学 关键护理医学
背景情况:
- 心室隔膜破裂 (VSR) 是心肌梗塞 (MI) 后的一种罕见,危及生命的并发症.
- 对VSR修复的最佳手术时间仍在争论中,有证据表明,由于痕组织的形成,延迟干预可能会改善结果.
- 机械循环支持 (MCS) 可以帮助血液动力学稳定,并促进有关手术时间的决定.
研究的目的:
- 报告两名患有心肌梗塞相关的VSR的患者的治疗和结果.
- 评估VA-ECMO (静脉动脉外体膜氧化) 稳定后延迟手术的作用.
- 突出VA-ECMO作为复杂的VSR病例中心脏移植的桥梁.
主要方法:
- 关于两名被诊断患有VSR后MI的患者的病例报告.
- 使用VA-ECMO进行血液动力学稳定和优化.
- 为修复VSR而推迟进行手术.
- 对结果的评估,包括对心脏移植的需要.
主要成果:
- 这两位患者都需要VA-ECMO来稳定.
- 尽管最初试图修复VSR,但结果在两种情况下都需要心脏移植.
- VA-ECMO为决策提供了关键的时间,并促进了移植的桥梁.
结论:
- 在VA-ECMO的支持下,对VSR后心脏病发作的延迟手术干预可能是一个可行的策略.
- VA-ECMO在稳定患者方面发挥着至关重要的作用,并作为通往最终治疗的桥梁,例如心脏移植.
- 虽然VSR修复可能会失败,但MCS可以提高存活率,并在复杂的情况下促进移植.
更多相关视频
08:19Transthoracic Echocardiography to Assess Post-Resuscitation Left Ventricular Dysfunction After Acute Myocardial Infarction and Cardiac Arrest in Pigs
Published on: July 12, 2022
2.7K
03:40Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting
Published on: January 17, 2025
228
相关概念视频
01:30Acute Coronary Syndrome III: Diagnostic Studies
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
01:29Cardiomyopathy V: Interprofessional Care
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
01:29Pulmonary Embolism I: Introduction
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
01:19Pulmonary Embolism I: Introduction
A blood clot, or thrombus, is a semi-solid mass composed of fibrin, platelets, and red blood cells. When it forms within a vessel, it can obstruct blood flow, known as thrombosis. If part of the clot detaches, it becomes an embolus that can travel and block distant vessels. When this occurs in the pulmonary arteries, it causes a condition known as pulmonary embolism (PE).Origin and ImpactMost often, the embolus originates from a thrombus in the deep veins of the lower limbs, a condition called...