在急性心脏病性休克中手术安置Impella的结果
Timothy J George1, Jenelle Sheasby1, J Michael DiMaio1
1Department of Advanced Heart Failure and Mechanical Circulatory Support, Baylor Scott & White The Heart Hospital - Plano, Plano, Texas.
Proceedings (Baylor University. Medical Center)
|June 19, 2023
概括
手术植入的Impella设备 (Impella 5.0和5.5) 改善了血液动力学,并减少了心脏性休克患者的血管活性药物需求. 这些设备为严重心力衰竭患者提供可接受的结果和生存率.
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
- 机械循环支持 机械循环支持
背景情况:
- 皮穿式Impella器件已经确立,但对更大,手术植入的Impella器件的数据有限.
- 急性心脏性休克需要先进的支持策略来改善患者的治疗结果.
研究的目的:
- 评估手术植入的Impella 5.0和5.5器件在经历急性心脏性休克的患者中的实用性和结果.
- 为了评估存活率,血液动力学改善,末端器官输液,以及与外科Impella植入相关的手术并发症.
主要方法:
- 在2012年至2022年间对90个外科Impella (5.0和5.5) 植入物的回顾性审查.
- 主要结局:生存率. 二次结局:血液动力学状况,末端器官输液和手术并发症.
- 多变量建模以确定与死亡率相关的因素.
主要成果:
- 移除设备后的总生存率为77%,出院率为65%,一年生存率为54%.
- 手术Impella安置显著降低了对血管活性输液的需求,并减少了酸性疾病.
- 较高的植入前血管活性药物使用与30天死亡率有很强的相关性.
结论:
- 手术Impella支持与改善血液动力学和减少急性心血管性休克的血管活性药物需求有关.
- 这些设备显示可接受的发病率和死亡率,为高级心力衰竭支持提供了可行的选择.
- 进一步的研究应该探索最佳的患者选择和impella植入术的长期结果.
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