左冠状动脉起源异常术后的短期左心辅助

目的总结心脏术后严重左心功能衰竭患儿使用左心辅助装置(LVAD)的临床经验。方法 3例左冠状动脉起源异常的患儿,平均年龄7个月,术后左心衰竭短期使用左心辅助。结果 3例患儿全部顺利脱机,存活出院。辅助流量100~120 ml/(kg·min),辅助时间72~98 h。主要的并发症是出血、感染、右心功能不全。结论离心泵左心辅助不像ECMO那样具有普遍适用性,但是对于一些特殊病例是非常有效的。其成功和病例的选择、安装的时机、并发症的防治、监护人员的专业非常有关。

The clinical experience of left ventricular assist device applied postoperatively in patients with anomalous origin of the left coronary artery from the pulmonary artery

Objective To evaluate the the clinical experience of left ventricular assist device （LVAD） applied postoperatively in patients with anomalous origin of the left coronary artery from the pulmonary artery. Methods Between Jan. 2012 and May 2013, three patients （ median age 7 months ） underwent repair operation for the anomalous origin of the left coronary artery from the pulmonary artery. Results All patients were well recovered and discharged cured. The flow rate of LVAD was 100 - 120 ml/kg ~ min. The as- sisting time was 72 - 98 hours. The main complications were haemorrhage, infection and disfunction of right heart. Conclusion The LVAD is not as popular as ECMO, but it is relatively important in special patients. The succeed of LVAD closely relates to the factors such as the case of patient, the time of performing, the treatment for complications and knowledge of physician.