| Japanese |
|---|
| Title | 心肺補助中の経大動脈左室ベントの効果─大動脈内バルーンパンピング併用の影響─ |
|---|
| Subtitle | 原著 |
|---|
| Authors | 栗原寿夫 |
|---|
| Authors(kana) | |
|---|
| Organization | 東京女子医科大学付属日本心臓血圧研究所循環器外科 |
|---|
| Journal | 循環制御 |
|---|
| Volume | 21 |
|---|
| Number | 3 |
|---|
| Page | 283-289 |
|---|
| Year/Month | 2000/ |
|---|
| Article | 原著 |
|---|
| Publisher | 日本循環制御医学会 |
|---|
| Abstract | 経皮的心肺補助装置(PCPS)を代表とする静動脈バイパス(VAB)は重症心不全症例に対し使用され, その有効性が示されている. その一方で本法は高流量の際に左室後負荷が増大するため左室補助効果については疑問が残る. 渋谷, 北村らは経大動脈的左室ベント(TACV)を考案し, その左室補助効果についての有効性を報告した1). 本研究では臨床例でVAB(PCPS)と併用されることの多い大動脈内バルーンパンピング(IABP)を使用した場合のTACVの有効性について検討した. 雑種イヌ13頭の正常心を用いてVAB中のTACVによる左室負荷軽減の効果を評価した. TACVを用いることにより左室仕事量は減少し, IABP併用例では更に圧負荷の減少が認められた. 左室のエネルギー充電効率に関しては, Baseline群に比べTACV併用群で特に有意に増加した. 以上の結果, TACVは重症左心不全に対するPCPSの補助手段として有用であることが示唆され, IABP併用は圧負荷の軽減において効果があることが示された. |
|---|
| Practice | 基礎医学・関連科学 |
|---|
| Keywords | Transaortic catheter venting, Percutaneous cardiopulmonary support, Intraaortic balloon pumping, Left ventricular unloading, Cardiac energy charge |
|---|
| English |
|---|
| Title | Beneficial Effect of Transaortic Catheter Venting During Cardiopulmonary Support -Influence of Intraaortic Balloon Pumping- |
|---|
| Subtitle | |
|---|
| Authors | Hisao KURIHARA |
|---|
| Authors(kana) | |
|---|
| Organization | Department of Cardiovascular Surgery,The Heart Institute of Japan,Tokyo Women's Medical University |
|---|
| Journal | Circulation Control |
|---|
| Volume | 21 |
|---|
| Number | 3 |
|---|
| Page | 283-289 |
|---|
| Year/Month | 2000/ |
|---|
| Article | Original article |
|---|
| Publisher | Japan Society of Circulation Control |
|---|
| Abstract | Recently percutaneous cardiopulmonary support (PCPS) has been frequently used for acute cardiogenic shock as a kind of emergency venoarterial bypass (VAB). Patients with severe cardiac failure can be saved PCPS and intraaortic balloon pumping (IABP). But some of them can't be weaned from the circulatory support. We suppose that insufficient unloading of the left ventricle (LV) with blood stagnation is a main cause of unsuccessful LV recovery during PCPS and IABP. This investigation was undertaken to evaluate effectiveness of additional transaortic catheter venting (TACV) for LV unloading. Thirteen mongrel dogs (range of body weight 14-20 kg) underwent VAB with TACV and IABP. In addition to monitoring of standard hemodynamic parameters, the slope of LV end-systolic pressure-volume relation (Emax) during transient occlusion of the inferior vena cava, the slope of LV end-systolic pressure-stroke-volume relation (Ea), external stroke work (SW), LV pressure-volume area (PVA), potential energy (PE), and the slope of SW-end-diastolic volume relation (preload recruitable stroke work: PRSW) were assessed by means of a micro-tip manometer and a conductance catheter. LV work parameters were significantly reduced by TACV, and LV afterload was reduced with IABP support. Proposed cardiac energy charge index (PE/PVA) was significantly increased with TACV. These results suggested that TACV might be an effective technique for LV unloading during PCPS and additional IABP support might be useful for reduction of LV afterload. |
|---|
| Practice | Basic medicine |
|---|
| Keywords | Transaortic catheter venting, Percutaneous cardiopulmonary support, Intraaortic balloon pumping, Left ventricular unloading, Cardiac energy charge |
|---|