背景：患者，男，77 岁。因活动后呼吸困难及劳累性胸痛入院，完善相关检查后发现存在重度主动脉瓣狭窄及严重冠状动脉狭窄，随后行经导管冠状动脉介入治疗至右冠狭窄处植入支架。术后，患者突发心源性休克和心脏骤停，复苏后依赖于静脉-动脉体外膜肺氧合支持。检查：心电图，经胸廓的超声心动图，冠状动脉造影，计算机断层血管摄影。诊断：严重主动脉瓣狭窄合并心源性休克。治疗：为稳定患者血流动力学状态，早日拔除体外膜肺，患者被转运至导管室实施急诊经导管主动脉瓣置换术。
Citation：
陈鹏飞, 胡信群, 方臻飞. 如何治疗主动脉瓣狭窄合并体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
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Copyright © the editorial department of West China Medical Journal of West China Medical Publisher. All rights reserved
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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.
