小儿左心室辅助管道的设计及临床应用

The design and clinical application of left ventricular assist device circuit in pediatric patients

目的阐述小儿左心室辅助装置(LVAD)管路的设计和临床使用。方法对14例先天性心脏病(CHD)患儿因心内直视手术后左心功能不全实施左心室辅助。采用普通离心泵和泵头,与本院自行设计的管道连接使用。流量为80~150ml/(kg·min),肝素抗凝,维持激活凝血时间在150~180 s。结果脱机生存率为64.3%(9/14),出院生存率为57.2%(8/14)。除外科纠治和疾病本身原因外,未出现与管路设计和使用相关的并发症。结论本院自行设计的管路使用合理、安装简便,在左心辅助中起到了一定的作用。

Objective To evaluate the clinical applicationof a self-designed LVAD circuit in children with congenital heart disease （CHD）. Methods 14 patients of CHD underwent LVAD placement during the left heart failure postoperatively. All children were supported with ordinary manufacturers and centrifugal pumps, which were connected with the self-designed LVAD circuit. The flow rates were kept at 80-150 ml（ kg · min）, and the activated coagulation time was maintained between 150 s and 180 s. Results The rate of weaning off LVAD was 64.3% （9/14） , and the survival rate of hospital discharge was 57.2% （8/14）. Except for the com- plications that were directly related to surgery and cardiac function, no circuit-related complication was shown. Conclusions The LVAD circuit designed by ourselves is safe and easy to use in children. It plays an important role in left ventricular assist.