RESUMEN
We retrospectively evaluated early outcome and conducted this study to determine the predictive factors for percutaneous cardiopulmonary support (PCPS) weaning and hospital discharge. From January 2004 to December 2006, 92 patients diagnosed as cardiac or respiratory failure underwent PCPS using the Capiox emergent bypass system (Terumo, Tokyo, Japan). The mean+/-S.D. age was 56+/-18 (range, 14-85) years and 59 (64%) were male. The mean duration of PCPS was 90.9+/-126.0 h and that of cardiopulmonary resuscitation (CPR) was 51.1+/-27.8 min. The rate of weaning was 59/92 (64%) and the rate of survival to discharge was 39/92 (42%). The results indicated that the etiologic disease (myocarditis) and the cause of PCPS (cardiopulmonary arrest) are significantly correlated with weaning, whereas cardiopulmonary arrest and a shorter CPR duration (<60 min) are considerably correlated with survival. On the contrary, elderly patients (>75 years) have similar rates of weaning and survival compared with younger patients. PCPS provides an acceptable survival rate and outcome in patients with cardiac or respiratory failure. Prompt application and selection of patients with a specific disease (myocarditis) provides good results. It is also effective in elderly patients, providing hospital survival similar to that for younger patients.
Asunto(s)
Reanimación Cardiopulmonar , Oxigenación por Membrana Extracorpórea , Insuficiencia Cardíaca/terapia , Insuficiencia Respiratoria/terapia , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Reanimación Cardiopulmonar/efectos adversos , Reanimación Cardiopulmonar/mortalidad , Tratamiento de Urgencia , Oxigenación por Membrana Extracorpórea/efectos adversos , Oxigenación por Membrana Extracorpórea/mortalidad , Femenino , Paro Cardíaco/complicaciones , Paro Cardíaco/terapia , Insuficiencia Cardíaca/etiología , Insuficiencia Cardíaca/mortalidad , Humanos , Estimación de Kaplan-Meier , Tiempo de Internación , Masculino , Persona de Mediana Edad , Miocarditis/complicaciones , Miocarditis/terapia , Alta del Paciente , Selección de Paciente , Insuficiencia Respiratoria/etiología , Insuficiencia Respiratoria/mortalidad , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento , Adulto JovenRESUMEN
We report a very rare case of left Valsalva sinus aneurysm rupture into left atrium in a 55-year-old man with severe aortic regurgitation caused by aortic valve prolapse. The Valsalva sinus aneurysm rupture was clearly visualized with transesophageal echocardiography performed to further delineate the aortic valve pathology. The 3-dimensional reconstruction of multislice computed tomography images nicely visualized the left Valsalva sinus aneurysm.
