Application of extracorporeal membrane oxygenation rescue after heart transplantation right heart failure - report of 1 case.docVIP

 PAGE \* MERGEFORMAT 2 Application of extracorporeal membrane oxygenation rescue after heart transplantation right heart failure - report of 1 case Author: Fan Zou Wei-Zi-Jie Wang Zhengjun wholeheartedly Xu Chongen [Keywords:] extracorporeal membrane oxygenation; heart transplantation; right heart failure Right heart failure is a common complication after heart transplantation, but also lead to heart transplant patients after one of the common causes of death. Our hospital extracorporeal membrane oxygenation (ECMO) to rescue after heart transplantation in patients with severe right heart failure 1 case to be successful. A clinical data and methods Patients with Chen X, M, 26 years old, complained: anorexia, nausea, fatigue and 4 more than a month. Cardiac B-show left and right ventricle significantly increased (LV 7.11 cm, RV 3.36 cm) sections of cardiac events was significantly lower mobility, moderate mitral regurgitation, severe tricuspid valve regurgitation, apical mural thrombus there. ECG showed left ventricular major, V1-V3 sick rational Q-wave. Admission diagnosis: Dilated cardiomyopathy. Across the same kinds of hospitalized patients with heart transplantation in situ. Using double-lumen anastomosis, surgical success. Heart anastomosis 79 min, CPB 332 min, donor heart ischemic time 320 min. Postoperative 6h sober, after the first day of a stable hemodynamic parameters (MAP 80mmHg, HR 100 times / min, PAWP 8 ~ 10 mmHg, CVP 6 ~ 10 cmH2O). Fast heart rate occurs after the next morning (HR 120 ~ 130 times / min), low blood pressure (MAP 50 ~ 60 mmHg), CVP increased (20 cmH2O), decreased urine output, the application step-up drugs (dopamine 10 μ g / ( kg * min) and the diuretic effect of poor cardiac B-show left ventricular myocardial activity, right ventricular enlargement, exercise poor estimate MPAP about 30 mmHg, measured blood cTnI of 112 ng / ml (normal