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英文誌(2004-)

Journal of Medical Ultrasonics

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1994 - Vol.21

Vol.21 No.07

Original Article(原著)

(0437 - 0442)

経皮的左心バイパス補助循環法における心腔内血行動態および安全性に対する経食道エコー法による検討−臨床的・病理学的検討−

Transesophageal Echocardiographic Study of the Hemodynamics and Safety in Cases with Percutaneous Left Heart Bypass Support

宮本 直政, 許 俊鋭, 元山 猛, 今福 博司, 相原 聡, 中田 一之, 尾本 良三, 土肥 豊

Naomasa MIYAMOTO, Shunei KYO, Takeshi MOTOYAMA, Hiroshi IMAFUKU, Satoshi AlHARA, Kazuyuki NAKATA, Ryozo OMOTO, Yutaka DOHI

埼玉医科大学心臓病センター

Saitama Heart Institute, Saitama Medical School

キーワード : Transesophageal echocardiography, Interatrial shunting, Atrial septal defect, Transseptal cannulation, Percutaneous left heart bypass support

To evaluate the hemodynamics and safety of percutaneous transseptal left heart bypass support (PLHBS), transesophageal echo (TEE) monitoring was performed on 9 patients (males, mean age=61) during PLHBS. PLHBS support was indicated for acute myocardial infarction (AMI) with cardiogenic shock in 5 patients, for circulatory support during balloon coronary angioplasty (PTCA) in 3 patients, and for dilated cardiomyopathy (DCM) in one patient.
The location of the left atrial cannula was clearly observed in TEE images, and no right-to-left reversed shunt flow was observed around the cannula through the interatrial septum. In one patient, spontaneous echo and thrombus were observed in the left ventricle and the ascending aorta.
Autopsies of 5 patients (mean age=60) revealed that the puncture site was properly located in the fossa ovalis in all patients, and no tearing was observed at the puncture site. The puncture was found to be completely healed in 2 patients at autopsy.
Thus, TEE is an effective monitoring tool for evaluating hemodynamics and for determining the safety of the PLHBS procedure.