UNASSIGNED: A 58-year-old male patient in cardiogenic shock with a very large ventricular septal (VSD) defect (4.9 cm × 5 cm) due to myocardial infarction was presented in our department. Acute stabilization was achieved using peripheral venoarterial extracorporeal membrane oxygenation (VA-ECMO) support. Neither surgical nor interventional therapy was considered as a sufficient option due to the unsuitable anatomy of the VSD and the patient was listed for heart transplantation. After 2 weeks on ECMO, bleeding and infectious complications occurred. Due to organ shortage, urgent implantation of the bioprosthetic total artificial heart (TAH) Aeson device (CARMAT) remained the only useful strategy to achieve a mid- or long-term bridge to transplantation. After successful implantation and good recovery with the Aeson device, the patient was transplanted 4 weeks after implantation.
UNASSIGNED: Post-infarction ventricular septal defects are highly challenging and are commonly associated with a poor prognosis. The implantation of the new Aeson TAH device is a promising therapeutic option, allowing a safe and long-term bridging to heart transplantation.
■我科介绍了一名58岁的男性心源性休克患者,该患者因心肌梗死导致室间隔非常大(VSD)缺损(4.9cm×5cm)。使用外周静脉动脉体外膜氧合(VA-ECMO)支持可实现急性稳定。由于VSD的解剖结构不合适,手术或介入治疗均未被认为是足够的选择,并且患者被列为心脏移植。在ECMO上两周后,出血和感染并发症发生。由于器官短缺,紧急植入生物假体全人工心脏(TAH)Aeson装置(CARMAT)仍然是实现中长期移植桥接的唯一有用策略。在成功植入和使用Aeson装置良好恢复后,患者在植入后4周进行移植。
■梗死后室间隔缺损具有很大的挑战性,通常与不良预后相关。新的AesonTAH装置的植入是一个很有前途的治疗选择,允许心脏移植的安全和长期桥接。