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在患有严重左心室功能障碍的高风险患者中,用微轴流保护的皮肤穿透性肺替换

Anastasia Schleiger¹, Julia Moosmann¹, Pia Lanmüller²

¹Department of Congenital Heart Disease-Pediatric Cardiology, Deutsches Herzzentrum der Charité, Berlin, Germany; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.

JACC. Case reports

|November 20, 2025

概括

穿皮肺置换对于门功能障碍患者来说是安全的. 使用穿皮左心室辅助装置 (Impella CP) 可以预防接受此程序的高风险患者心力衰竭.

科学领域:

心脏病学心脏病学
心血管外科心血管外科
干预心脏病学干预心脏病学

背景情况:

肺功能障碍带来风险,特别是在患有先前心室功能障碍的患者中,由于重振过程中的血液动力学变化.
最少侵入性皮肤穿透性肺置换 (PPVR) 是一个可行的策略,但高风险患者可能会经历血液动力学不稳定.
急性心力衰竭是PPVR的潜在并发症,患有双心室功能受损的患者.

研究的目的:

描述通过皮肤输入的左心室辅助器件 (Impella CP) 在经过透气管肺置换 (TPVR) 的高风险患者的周围手术使用.
评估Impella CP支持在重度双心脏功能障碍患者的TPVR期间预防血液动力失补偿的安全性和有效性.

主要方法:

一个涉及三名患者 (45-63岁) 的病例系列,患有已修复的先天性心脏病和严重的双心室功能障碍.
同时通过皮肤植入Impella CP辅助装置和使用Venus P-Valve进行透气管肺置换.
在手术期间和之后监测血液动力学稳定性和患者的结果.

主要成果:

在这三名患者中,透气管肺置换成功地进行,没有并发症.
患者在手术后1至3天内停止使用Impella CP支持.
在随访期间,临床状况和双心脏功能有所改善.

结论:

使用Impella CP的周围手术机械循环支持可以促进高风险患者的TPVR.
使用Impella CP是一种安全有效的策略,可以预防TPVR期间的血液动力失补偿.
这种方法可以改善肺置换的严重心室功能障碍患者的治疗结果.

关键词:

左心室功能障碍是什么机械循环支持机械循环支持通过皮肤植入肺的肺植入.费洛特的四部曲.

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