The importance of biventricular failure in patients with postoperative cardiogenic shock.
The importance of biventricular failure in patients with postoperative cardiogenic shock.
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双心室衰竭对术后心源性休克患者的重要性。
DOI：
10.1016/s0003-4975(10)62516-7
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发表时间：
1985
期刊：
影响因子：
--
通讯作者：
V. Willman
中科院分区：
文献类型：
--
作者：
D. Pennington;J. Merjavy;M. Swartz;J. Codd;H. Barner;D. Lagunoff;H. Bashiti;G. Kaiser;V. Willman
为了评估严重双心室衰竭在开心术后心衰患者中的重要性，我们分析了30例使用心室辅助装置（VADs）治疗的患者在5年期间的数据。所有患者术后均有严重的难治性心室衰竭和主动脉内球囊（IAB）。术前心室功能评估不能预测哪些患者需要VADs。然而，围手术期心肌梗死的发展是术后VAD支持需求的重要决定因素。20例患者仅接受左VAD （LVAD）。其中4人有孤立性左心室衰竭；3只断奶，2只存活。16例仅接受LVAD的双心室衰竭患者均未脱机。另外10例双心室衰竭患者接受双心室支持，要么有右VAD和IAB，要么有两个VAD。10例患者中，5例断奶，3例存活。考虑到所有26例双心室衰竭患者，接受双心室机械支持的患者（10）比仅接受LVAD的患者（0/16）有更好的断奶（5/10）和生存（3/10）的机会（p< 0.025）。我们的结论是，双心室衰竭在心切术后心衰患者中很常见，并且通常是围手术期梗死的结果。孤立性左心室衰竭患者仅使用LVAD效果良好，而双心室衰竭患者则需要双心室机械支持才能生存。
To evaluate the importance of severe biventricular failure in patients with postcardiotomy ventricular failure, we analyzed the data from 30 patients treated with ventricular assist devices (VADs) over a five-year period. All patients had profound postoperative ventricular failure refractory to drugs and an intraaortic balloon (IAB). Evaluation of preoperative ventricular function did not allow prediction of which patients would require VADs. However, the development of perioperative myocardial infarction was an important determinant of the need for postoperative support with a VAD. Twenty patients received only a left VAD (LVAD). Four of them had isolated left ventricular failure; 3 were weaned, and 2 survived. None of the 16 patients with biventricular failure who received only an LVAD were weaned. Ten other patients with biventricular failure received biventricular support, either with a right VAD and IAB, or with two VADs. Of these 10 patients, 5 were weaned and 3 survived. Considering all 26 patients with biventricular failure, those receiving biventricular mechanical support (10) had a better chance (p< 0.025) of being weaned (5/10) and surviving (3/10) than those who received only an LVAD (0/16). We conclude that biventricular failure is common in patients with postcardiotomy ventricular failure and is often the result of perioperative infarction. While patients with isolated left ventricular failure did well with an LVAD only, those with biventricular failure required biventricular mechanical support for survival.
影响因子：
4.8
作者：
Rackley,CE;RussellJr,RO;Mantle,JA;Rogers,WJ;Papapietro,SE;Schwartz,KM
通讯作者：
Schwartz,KM
心脏手术后心源性休克患者的心室辅助泵血。
DOI：
10.1056/nejm198112313052702
发表时间：
1981
期刊：
The New England journal of medicine
影响因子：
--
作者：
Pierce,WS;Parr,GV;Myers,JL;PaeJr,WE;Bull,AP;Waldhausen,JA
通讯作者：
Waldhausen,JA