.

王志坚在心源性休克且泵衰竭患者中应用l

桡动脉介入治疗(transradialintervention,TRI)具有术后不需限制活动、缩短住院时间、患者接受程度高等优点。由泰尔茂公司全力协办的“介入心声音”——第九届年度精彩TRI病例大赛于中国心脏大会(CHC)期间已决出中国区四强,四强选手病例受邀前往日本复杂心血管治疗学大会(ComplexCatheterTherapeutics,CCT),在“中日TRI病例竞赛”现场展开激烈角逐。本届TRI病例大赛总冠军将花落谁家?敬请期待10月27日《门诊》前方记者于日本CCT现场为您带来盛况报道!

来自首都医科医院的王志坚医师分享了一例心跳骤停伴心脏泵衰竭病例。患者在转院途中出现心跳骤停40分钟,医师综合应用PIE-2R模式,即有效的循环呼吸支持系统:Pacemaker、IABP、ECMO、Respiratory与Revascularization成功挽救患者生命。以下为来自王志坚医师的病例的诊断资料与手术详细过程展示,以期各位专家学者交流探讨。

Generalinformation(Male,52years)

Presentillness:Suddenonsetofretrosternalchestpain.Rushedtotheemergencydepartment,Cardiacarrestfor1.51.5hours(40minutes).MCPR+50minutesofECPR.

Pasthistory:Nonhypertensive,nopriorhistoryofD.O.E.noknownhistoryofDM.

Riskfactor:nosmoking.

UCG:Globalakinetic,EF16%.

EKG:VFib.

electrocardiogram:Continue4hoursofCPR,numerouselectriccardioversion.PersistentVFAnyhopeforthispatient?Giveup?

ECMOwasused4hoursafterCPR:

ECMOassistedPCI(EPCI)

Setp1:

Setp2:PEA-PCI.

Discuss:Theculpritvessel(TheECGwasamess):RCA?LAD?Strategy:Completerevascularization?Onlyculpritvessel?

Setp3:GivingHopetotheHopeless.

Setp4:TheBeaconofHope.

Setp5:TriedtoopentheLADbutfailed.CTO?

Setp6:Afterrevascularization,thepatientgotheartrhythmafterelectriccardioversionJ.IABPwasinserted.

Casesummary

PIE-2R:ThemodeandfuturedirectionforresuscitationinAMI-CS.

WhatisPIE-2R:PIE-2Ristheapplicationof


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