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心脏移植接受者之前使用左心室辅助装置的结果与中风相关
Aaron Shoskes1, Merry Huang1, Catherine Hassett2
1Department of Neurology, Neurological Institute, Cleveland Clinic, 9500 Euclid Avenue s100a, Cleveland, OH 44195, USA.
概括
左心室辅助器械 (LVAD) 中风患者的移植结果类似,但接受移植的患者较少. 与LVAD相关的中风病史不应排除心脏移植.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 移植医学 移植医学
背景情况:
- 左心室辅助器件 (LVADs) 在末期心力衰竭中提高存活率.
- LVAD与缺血性中风和内出血 (ICH) 有关.
- 与LVAD相关的中风对心脏移植候选人和结果的影响尚不清楚.
研究的目的:
- 评估与LVAD相关的中风对心脏移植资格的影响.
- 为了比较患有和没有LVAD相关性中风的患者的移植后存活率和结果.
主要方法:
- 在2004年至2021年期间接受LVAD的成年患者的回顾性评估.
- 鉴定经历过缺血性中风或LVAD植入后ICH的患者.
- 对心脏移植接受者有或没有LVAD相关性中风病史的比较生存分析.
主要成果:
- 在917名LVAD患者中,有244人接受了移植,其中25人先前患有LVAD相关性中风.
- 移植后的一年和两年的存活率为中风患者的100%和95%,而非中风患者的92%和90% (p=0.156;p=0.323).
- 移植后中风发生率在各组之间相似 (4-5%对比5-6%,p>0.7).
结论:
- 与LVAD相关的中风患者接受心脏移植的可能性较低.
- 然而,移植患者的移植后存活率和结果相似.
- 患有与LVAD相关的中风史不应成为心脏移植的绝对禁忌.
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