Caval Inflow Occlusion during Surgery for Tricuspid Infective Endocarditis: Report of a Case

以上下腔靜脈阻斷來進行開心手術，據發表已經超過五十年；在人工心肺機和體外循環使用還不普及的時代，這種手術曾被廣泛地使用。它提供二分鐘的安全空間，讓心臟外科醫師在不使用體外循環的情況下完成開心手術。然而，這種手術方式在現代已逐漸式微，尤其是成人的應用範疇。在此我們提出三個類似的個案報告，採用上下腔靜脈阻斷進行三尖瓣膜手術，成功地治療因嚴重感染性心內膜炎所導致的贅生物肺部栓塞、敗血症及心臟衰竭的經驗。

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並列摘要

The technique of normothermic caval inflow occlusion was introduced more than 50 years ago, and it was well established and used extensively before the era of cardiopulmonary bypass. It had been used in various cardiac situations where a period of up to 2 minutes of intracardiac exposure was sufficient. However, this technique was rarely used recently, especially for adult cardiac procedures. Almost every open heart surgery was performed under the assistance of cardiopulmonary bypass which provided a motionless and bloodless surgical field. Here we report our experience of tricuspid valve surgery using caval inflow occlusion in adults. Three infective endocarditis patients with multiple pulmonary emboli, congestive heart failure and uncontrolled sepsis underwent tricuspid valve vegetectomy without cardiopulmonary bypass. Right atria were opened and infected leaflets were excised after occlusion of both vena cava. All these patients had good recovery. The detailed surgical managements were described.

並列關鍵字

inflow occlusion ； tricuspid valve ； infective endocarditis

國際替代計量

Caval Inflow Occlusion during Surgery for Tricuspid Infective Endocarditis: Report of a Case

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