経大動脈左室ベントを併用した心肺補助による左室負荷軽減効果の検討 : 左室energy chargeからみた評価

概要

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Insufficient unloading of the left ventricle (LV) with blood stagnation is a limitation of percutaneous cardiopulmonary support (PCPS). The purpose of this study was to evaluate the effect of transaortic catheter venting (TACV; by a 6 Fr. pigtail catheter) for LV unloading with venoarterial bypass (VAB). Eleven adult mongrel dogs (12～20 kg) underwent VAB with TACV. Bypass flow ranged from 0.8～1.2 L/min and TACV flow ranged from 160～240 ml/min. With standard hemodynamic monitoring, the slope of the LV end-systolic pressure-volume relationship (Emax), aortic elastance (Ea), LV stroke work (SW), preload recruitable stroke work (PRSW) , LV pressure-volume area (PVA) and potential energy (PE) were assessed using a micro-tip manometer and a conductance catheter in each condition (baseline, VAB, VAB with TACV). The TACV combined support significantly reduced LV total energy (PVA) and LV work (SW) in comparison with the baseline levels and VAB. The LV energy charge ratio (PE/PVA) was significantly increased by TACV (27.8 ± 2.4%→37.6 ± 2.6%: p<0.01). These results suggest that TACV might be an effective technique for LV unloading during PCPS.
東京女子医科大学の論文
2000-09-25