如何治療主動脈瓣狹窄合并體外膜肺氧合支持下的心源性休克_West China Medical Journal

Authors：

陳鵬飛 , 胡信群 ,  方臻飛

Corresponding?author：

方臻飛, Email: fangzhenfei@csu.edu.cn

Keywords：

主動脈瓣狹窄; 經導管主動脈瓣置換術; 心源性休克; 體外膜肺氧合

DOI：

10.7507/1002-0179.201712157

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背景：患者，男，77 歲。因活動后呼吸困難及勞累性胸痛入院，完善相關檢查后發現存在重度主動脈瓣狹窄及嚴重冠狀動脈狹窄，隨后行經導管冠狀動脈介入治療至右冠狹窄處植入支架。術后，患者突發心源性休克和心臟驟停，復蘇后依賴于靜脈-動脈體外膜肺氧合支持。檢查：心電圖，經胸廓的超聲心動圖，冠狀動脈造影，計算機斷層血管攝影。診斷：嚴重主動脈瓣狹窄合并心源性休克。治療：為穩定患者血流動力學狀態，早日拔除體外膜肺，患者被轉運至導管室實施急診經導管主動脈瓣置換術。

Citation： 陳鵬飛, 胡信群, 方臻飛. 如何治療主動脈瓣狹窄合并體外膜肺氧合支持下的心源性休克. West China Medical Journal, 2018, 33(2): 223-229. doi: 10.7507/1002-0179.201712157 Copy

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1. Baumgartner H, Falk V, Bax JJ, et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J, 2017, 38(36): 2739-2791.
2. Leon MB, Smith CR, Mack M, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med, 2010, 363(17): 1597-1607.
3. D’Ancona G, Pasic M, Buz S, et al. Transapical transcatheter aortic valve replacement in patients with cardiogenic shock. Interact Cardiovasc Thorac Surg, 2012, 14(4): 426-430.
4. Ganapathi AM, Hirji SA, Wang A, et al. Bridge to long-term mechanical circulatory support with a left ventricular assist device: novel use of transcatheter aortic valve replacement. Ann Thorac Surg, 2015, 99(4): e91-e93.
5. Summers MR, Mick S, Kapadia SR, et al. Emergency valve-in-valve transcatheter aortic valve replacement in a patient with degenerated bioprosthetic aortic stenosis and cardiogenic shock on veno-arterial extracorporeal membrane oxygenation. Catheter Cardiovasc Interv, 2017. doi: 10.1002/ccd.26990.

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West China Medical Journal

如何治療主動脈瓣狹窄合并體外膜肺氧合支持下的心源性休克

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