Successful Blade Atrial Septostemy in a Patient With Severe Primary Pulmonary Hypertension : A Case Report
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概要
- 論文の詳細を見る
Blade atrial septostomy (BAS) for pulmonary hypertension has increased long-term survival and is an effective and palliative preliminary to heart and/or lung transplantation. We treated an 18-year-old woman with severe pulmonary primary hypertension whose symptoms had worsened as a resulted low cardiac output. The patient's right ventricular pressure was 150/23 ramrig, cardiac index (CI) 1.0 L/min per m^2, and she showed signs and symptoms of severe primary pulmonary hypertension. We performed BAS successfully, paying particular attention to the following points. To maintain pulmonary blood flow after creating an atrial right-to-left shunt, the patient was infused intravenously with packed red blood cells and volume expander. Oxygen delivery was also increased by the transfusion of packed red blood cells. To avoid unacceptable hypoxemia immediately after the procedure, the atrial septum was initially incised with a very small-blade catheter. Nine months after the BAS, catheterization revealed a decrease in mean pulmonary arterial pressure to 73 mmHg and an increase in CI to 2.5 L/min per m^2. Thirteen months after the BAS, the patient died as a result of progressive worsening of right-sided heart failure. We concluded that BAS could be successful in patients with severe pulmonary hypertension providing attention is paid to the patient's condition and that BAS is an effective therapy for prolonging survival.
- 社団法人日本循環器学会の論文
- 1997-09-20
著者
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Iwamoto Mari
Department Of Pediatric Cardiology Yokohama City University School Of Medicine
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Imanishi Masahito
Department Of Internal Medicine
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TAKIGIKU Kiyohiro
Department of Pediatric Cardiology, Nagano Children's Hospital
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Shibata Toshimitsu
Shibata Clinic
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Iwamoto Mari
Department Of Cardiovascular Medicine Yokohama City University Medical Center
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Shibata Toshimitsu
Department Of Pediatrics Yokohama City University
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Mitani Isao
藤沢市民病院
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Yasui Kiyoshi
Department of Paediatrics, Yokohama City University Medical Center
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Takigiku Kiyohihiro
Department Of Pediatric Cardiology Yokohama City University School Of Medicine
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Takigiku Kiyohiro
Department Of Pediatric Cardiology Nagano Children's Hospital
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Mitani Isao
Department Of Pediatric Cardiology Yokohama City University Hospital
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Takigiku Kiyohiro
Department Of Pediatric Cardiology Yokohama City University Hospital
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Yasui Kiyoshi
Department Of Paediatrics Yokohama City University Medical Center
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Yasui Kiyoshi
Department Of Molecular Genetics National Institute Of Genetics
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Shibata Toshimitsu
Research Committee On Long Qt Syndrome In Children In The Japanese Society Of Pediatric Cardiology A
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Takigiku Kiyohiro
Department Of Medical Science And Cardiorenal Medicine Yokohama City University Graduate School Of Medicine
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TAKIGIKU Kiyohiro
Department of Cardiovascular Surgery and cardiology, Nagano Children's Hospital
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