用圈套导管矫直主动脉错折微轴流泵

Q4 Medicine

JACC. Case reports Pub Date : 2025-10-01 DOI:10.1016/j.jaccas.2025.105218

Marko Šustić MD, PhD , Tomislav Jakljević MD, PhD , Zoran Miovski MD, PhD , Davorka Lulić MD , David Gobić MD, PhD , Luka Bastiančić MD , Josip Aničić MD , Vjekoslav Tomulić MD, PhD

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引用次数: 0

摘要

在心源性休克患者中，微轴流泵部署后在主动脉内错误折叠是一种罕见但严重的并发症，给治疗带来了重大挑战。病例总结：一名35岁女性因流行性心肌炎住院。虽然最初血流动力学稳定，但24小时后发生心源性休克，需要植入Impella CP装置。她被转移到重症监护室，很快就出现了设备故障的迹象。透视显示升主动脉Impella CP呈扭曲的z形构型。使用圈套技术，该装置在降主动脉中被拉直，并成功地通过股鞘取出。目前，没有既定的指导方针存在管理微轴流泵错误折叠。本病例展示了一种安全有效的经皮手术治疗该并发症的方法。圈套技术提供了一种安全有效的经皮方法来回收扭结的微轴流泵装置。

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Straightening Misfolded Microaxial Flow Pump in the Aorta Using a Snare Catheter

Background

In patients with cardiogenic shock, misfolding of a microaxial flow pump within the aorta after deployment is a rare but serious complication that presents a significant therapeutic challenge.

Case Summary

A 35-year-old woman was hospitalized with influenza myocarditis. Although initially hemodynamically stable, she developed cardiogenic shock 24 hours later, requiring implantation of an Impella CP device. She was transferred to the intensive care unit, where signs of device malfunction soon appeared. Fluoroscopy revealed a distorted, Z-shaped configuration of the Impella CP in the ascending aorta. Using a snare technique, the device was straightened in the descending aorta and successfully retrieved via the femoral sheath.

Discussion

Currently, no established guidelines exist for managing microaxial flow pump misfolding. This case demonstrates a safe and effective percutaneous retrieval approach for this complication.