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The Application of a Bi-ventricular Assist Device for a Low Weight (2.4 kg) Neonate with Coarctation of the Aorta and Critical Aortic Stenosis

대동맥 축착증 및 심한 대동맥 협착을 가진 저체중 신생아(2.4 kg)의 수술 전후 발생한 심실 기능 부전의 치료에 대한 양심실 보조 장치 적용 치험 예

  • Kwak, Jae-Gun (Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital) ;
  • Park, Chun-Soo (Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital) ;
  • Lee, Chang-Ha (Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital) ;
  • Lee, Cheul (Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital)
  • 곽재건 (부천세종병원 흉부외과) ;
  • 박천수 (부천세종병원 흉부외과) ;
  • 이창하 (부천세종병원 흉부외과) ;
  • 이철 (부천세종병원 흉부외과)
  • Received : 2009.12.06
  • Accepted : 2009.12.15
  • Published : 2010.06.05

Abstract

A 5-day-old neonate (body weight=2.4 kg) with coarctation of the aorta and critical aortic stenosis underwent an interventional balloon valvuloplasty for aortic stenosis. During the intervention, cardiac arrest occurred due to injury of the right carotid artery by the guide wire. An extracorporeal membrane oxygenator (ECMO) was applied. After 1 day's support, total surgical correction was achieved; however, in the immediate postoperative period, cardiac function was severely depressed. We applied a bi-ventricular assist device (bi-VAD) instead of an ECMO and we were able to wean the patient off the bi-VAD device after 3 days' support. The patient was discharged without severe complications.

대동맥 축착증 및 심한 대동맥 협착을 가진 생후 5일의 환자가 대동맥 협착을 해결하려는 중재적 시술 도중 유도 카테터에 의한 우측 경동맥 손상으로 인한 출혈 및 심낭 내 탐폰으로 인한 심정지가 발생하여 심폐소생술 후 체외막성산화기 보조를 받았다. 환자의 체중은 2.4 kg이었다. 1일 후 수술적 완전 교정술을 시행하였으나, 수술 직후 심한 심기능 저하로 인하여 양심실 보조 장치로 순환 보조를 하였고, 3일 후 양심실 보조 장치 이탈에 성공하였다. 이후 환자는 일반적인 치료 후 특별한 문제없이 퇴원하였다.

Keywords

References

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