TAVI术中紧急体外循环病例及规范修订

目的修订TAVI紧急体外循环规范。方法对完成经导管主动脉瓣植入术135例中, 5例术中因各种原因紧急建立体外循环行外科手术治疗。体外循环采用浅低温或者常温,中度血液稀释,使用Del Nido心脏停搏液行心肌保护。结果 5例患者平均体外循环时间为81.0±33.4 min,平均主动脉阻断时间为34.0±35.8 min,术后无相关并发症,均康复出院。根据体外循环中出现的相关问题建立并持续修订了相关规范。结论需要充分认识体外循环快速建立能力对TAVI手术的安全保障作用。

Cases and Regulation Revision of Emergency Cardiopulmonary Bypass during TAVI Operation

Objective To revise the emergency cardiopulmonary bypass regulation during transcatheter aortic valve implantation (TAVI) operation. Methods 5 cases of 135 patients who underwent surgical treatment of extracorporeal circulation for various reasons during TVAI surgery were investigated. Cardiopulmonary bypass was performed with mild hypothermia or normal temperature and moderate blood dilution. Meanwhile, Del Nido cardiac arrest fluid was used for myocardial protection. Results The average cardiopulmonary bypass time was 81.0±33.4 min in 5 patients, and the mean aortic occlusion time was 34.0±35.8 min. There were no related complications after the operations and all the patients were discharged smoothly. According to the problems that appeared in extracorporeal circulation, relevant regulation was established and continuously revised. Conclusion The security role of the ability to rapidly establish extracorporeal circulation for TAVI surgery should be fully recognized.