预防性静脉-动脉体外膜肺氧合支持下的经导管主动脉瓣植入术

Prophylactic Venous-Arterial Extracorporeal Membrane Oxygenation Supported Transcatheter Aortic Valve Implantation

经导管主动脉瓣植入术是治疗重度主动脉瓣狭窄的有效方法,当遇到诸如低射血分数的极高危患者,可能需要静脉-动脉体外膜肺氧合这样的机械设备的辅助治疗。现通过介绍1例成功在预防性静脉-动脉体外膜肺氧合应用下进行经导管主动脉瓣植入术的高危、低射血分数患者,进一步讨论当前国内外静脉-动脉体外膜肺氧合在经导管主动脉瓣植入术中的应用情况以及存在的问题。

Transcatheter aortic valve implantation(TAVI) is an efficient treatment of severe aortic valve stenosis.When we encounter extremely high risk patient like very low ejection fraction, we may need mechanical support among which venous-arterial extracorporeal membrane oxygenation(VA-ECMO) is a common and effective one.This article report a TAVI case which was advanced in years, with very low ejection fraction and varies complications supported under prophylatic VA-ECMO.This patient was successfully operated and leave hospital with remarkably improved ejection fraction.Eventually we reviewed VA-ECMO especially prophylactic VA-ECMO implication in TAVI therapy at present and the existing problems.