[A patient with severe ventricular tachycardia who was saved by prolonged extracorporeal lung and heart assist].
A 47-y-o man had been suffering from cardiac failure due to refractory ventricular tachycardia (VT) after myocardial infarction. He underwent resection of the left ventricular aneurysm and cryocoagulation of the arrhythmogenic foci. On the 2nd post-operative day, VT often recurred in spite of repeated cardioversion and drug therapy, and threatened his life, even under IABP. Therefore, a veno-arterial bypass route was made and extracorporeal lung and heart assist, ECLHA, was started with a heparin bonded Maxima lung on the following day. Even under ECLHA, VT continued to recur. Cryocoagulation of the VT foci was tried again, without immediate success. A record high dose of beta-blockers, given under the circulatory support by ECLHA, stopped VT on the following day. The patient was weaned from the ECLHA circuit 12 days after the first operation, then from IABP on the 14th day. During the 10 day course of surgeries and ECLHA, the patient had almost 100 defibrillations. But for ECLHA, we may say that the patient couldn't have survived two open heart surgeries, administration of a great amount of beta-blockers, and repeated cardiac arrest without neurological sequelae.
Tajiri
A
A
Department of Anesthesiology, Kumamoto University School of Medicine.
Okamoto
T
T
Otsu
T
T
Choi
H
H
Tang
S
S
Mizoguchi
S
S
Yanagi
F
F
Sakanashi
Y
Y
Gotoh
K
K
Matsumura
H
H
D000328:Adult; D005112:Extracorporeal Circulation; D015199:Extracorporeal Membrane Oxygenation; D006801:Humans; D008297:Male; D017180:Tachycardia, Ventricular / Q000601:surgery*