Left ventricular assist without thoracotomy: clinical experience with the Dennis method.

Left ventricular assist without thoracotomy: clinical experience with the Dennis method.
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无需开胸术的左心室辅助:丹尼斯法的临床经验。

DOI:
10.1016/0003-4975(94)90194-5
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发表时间:
1994
期刊:
The Annals of thoracic surgery
影响因子:
--
通讯作者:
McCarthy,DM
McCarthy,DM
中科院分区:
--
文献类型:
--
作者:
EdmundsJr,LH;Herrmann,HC;DiSesa,VJ;Ratcliffe,MB;Bavaria,JE;McCarthy,DM

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在2例患者中开发并实施了一种无需开胸即可提供左心室循环辅助的方法。使用荧光镜和超声心动图成像,通过将导管穿过房间隔(Dennis技术)从颈部插入左心房。为了便于腋动脉插管,将动脉导管连接到右腋动脉。左心房至腋动脉的血流由离心泵产生。两名患者以2.7至3.5 L/min灌注5天和6.5天。1例患者在灌注期间成功进行了冠状动脉成形术,1年后仍存活。另一名患者在实施循环辅助之前死于败血症和无尿。Dennis方法的持续左心室循环辅助避免了开胸手术,需要最少的手术,是便携式和廉价的,使用广泛可用的设备,特别适合于急性心肌梗死后的心源性休克患者。该方法是安全和成本效益,值得在选定的患者中更广泛的应用。
A method to provide left ventricular circulatory assistance without thoracotomy was developed and implemented in 2 patients. The left atrium is cannulated from the neck by passing a catheter across the interatrial septum (Dennis technique) using fluoioscopic and echocardiographic imaging. To facilitate ambulation, the arterial catheter is connected to the right axillary artery. Left atrial to axillary arterial flow is produced by a centrifugal pump. Two patients were perfused at 2.7 to 3.5 L/min for 5 and 6.5 days. One patient had successful coronary angioplasty during perfusion and remains alive 1 year later. The other patient died of sepsis and anuria that preceded implementation of circulatory assistance. The Dennis method of continuous left ventricular circulatory assistance avoids thoracotomy, requires a minimal operation, is portable and inexpensive, uses widely available equipment, and is particularly suitable for patients in cardiogenic shock after acute myocardial infarction. The method is safe and cost-effective, and merits wider application in selected patients.
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