CIRCULATORY SUPPORT IN INFANTS WITH POST-CARDIOPULMONARY BYPASS LEFT-VENTRICULAR DYSFUNCTION USING A LEFT-VENTRICULAR ASSIST DEVICE

被引：6

作者：

MOAT, NE ^{[1
]}

PAWADE, A ^{[1
]}

LEWIS, BC ^{[1
]}

SHORE, G ^{[1
]}

LAMB, RK ^{[1
]}

MONRO, JJ ^{[1
]}

机构：

[1] SOUTHAMPTON GEN HOSP,WESSEX CARDIOTHORAC CTR,SOUTHAMPTON SO9 4XY,HANTS,ENGLAND

来源：

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY | 1990年 / 4卷 / 12期

关键词：

HEART-ASSIST DEVICES; INFANT; POSTOPERATIVE CARE;

D O I：

10.1016/1010-7940(90)90056-6

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Extracorporeal membrane oxygenation has been advocated as the most appropriate mode of circulatory support in the paediatric age group for post-cardiopulmonary bypass ventricular dysfunction. The results in infants who have predominantly left ventricular failure, or who require such support in order to be weaned off bypass, have been disappointing. Three infants with severe left ventricular dysfunction following cardiopulmonary bypass for correction of congenital heart defects have been managed with a left ventricular assist device. Two required this form of circulatory support in order to be weaned from full bypass while in the third infant it was instituted for progressive left ventricular dysfunction postoperatively. All three were less than 10 kg in weight. Left atrial appendage to aortic bypass was effected using a closed loop circuit with a constrained vortex pump (Biomedicus). Duration of support ranged between 40 and 146 h. One infant made a complete recovery and was able to be discharged home 20 days postoperatively. Another made a circulatory recovery such that both mechanical and inotropic support could be discontinued but had sustained massive neurological damage. The third died of progressive left ventricular dysfunction. This experience with a left ventricular assist device demonstrates that it is technically feasible in small infants, and can be performed to good effect in infants with predominant left ventricular dysfunction following cardiac surgery. It may well be more appropriate than extracorporeal membrane oxygenation in this group of patients.

引用

页码：649 / 652

页数：4

共 14 条

[1]

Bartlett R.H., Andrews A.F., Toomasian J.M., Haiduc N.J., Gazzaniga A.B., Extracorporeal membrane oxygenation for newborn respiratory failure

[2]

forty-five cases, Surgery, 92, pp. 425-433, (1982)

[3]

Bartlett R.H., Gazzaniga A.B., Fong S.W., Jefferies M.R., Roohk H.V., Haiduc N.J., Extracorporeal membrane oxygenator support for cardiopulmonary bypass Experience in 28 cases, J Thorac Cardiovasc Surg, 73, pp. 375-386, (1977)

[4]

Bernhard W.F., La Fange C.G., Husain M., Yamamura N., Robinson T.C., Physiologic observations during partial and total left heart bypass, J Thorac Cardiovasc Surg, 60, pp. 807-817, (1970)

[5]

Elbeery J.R., Owen C.H., Savitt M.A., Davis J.W., Feneley M.P., Scott Rankin J., Van Rigt, Effects of the left ventricular assist device on right ventricular function, J Thorac Cardiovasc Surg, 99, pp. 809-816, (1990)

[6]

Fukamachi K., Asou T., Nakamura Y., Toshima Y., Masahiro O., Mitani A., Sakamoto M., Kishizaki K., Sunagawa K., Tokunaga K., Effects of left heart bypass on right ventricular performance, J Thorac Cardiovasc Surg, 99, pp. 725-734, (1990)

[7]

Kanter K.R., Pennington D.G., Weber T.R., Zambie M.A., Braun P., Martychenko V., Extracorporeal membrane oxygenation for post-operative cardiac support in children, J Thorac Cardiovasc Surg, 93, pp. 27-35, (1987)

[8]

Pennington D.G., McBride L.R., Swartz M.T., Kanter K.R., Kaiser G.C., Barner H.B., Miller L.W., Naunheim K.S., Fiore A.C., Willman V.L., Use of the Pierce-Donachy ventricular assist device in patients with cardiogenic shock after cardiac operations, Ann Thorac Surg, 47, pp. 130-135, (1989)

[9]

Pennington D.G., Merjavy J.P., Swartz M.T., Codd J.E., Barner H.B., Lagunoff D., Bashiti H., Kaiser G.C., Willman V.L., The importance of biventricular failure in patients with post-operative cardiogenic shock, Ann Thorac Surg, 39, pp. 16-26, (1985)

[10]

Pierce W.S., Parr G.S., Meyers J.L., Pae W.E., Bull A.P., Waldhausen J.A., Ventricular assist pumping in patients with cardiogenic shock after cardiac operations, N Eng J Med, 305, pp. 1606-1610, (1981)

← 1 2 →