相关实验视频
Updated: Jul 24, 2025

16:11
Implantation of the Syncardia Total Artificial Heart
Published on: July 18, 2014
35.3K
对于儿科心室辅助器件的可修改风险因素降低和在移植时持久的可修改风险因素的影响
Jason W Greenberg1, Kevin Kulshrestha1, Amalia Guzman-Gomez1
1Heart Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio.
The Journal of thoracic and cardiovascular surgery
|July 6, 2023
概括
室腔辅助装置 (VAD) 有助于减少儿童的可修改风险因素 (MRF). 然而,在移植时持续的MRF显著增加了死亡风险,需要在移植前进行优化.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 心血管外科心血管外科
- 移植医学 移植医学 移植医学
背景情况:
- 室腔辅助器件 (VADs) 改善了儿科心力衰竭患者的生存率.
- 之前的研究表明,VAD有助于减少可修改风险因素 (MRF).
- 需要与机构数据进行验证,以确认MRF减少及其对移植结果的影响.
研究的目的:
- 为了评估小儿VAD患者的MRF减少.
- 确定持续MRFs对心脏移植后生存的影响.
主要方法:
- 在移植时接受VAD的儿科患者的回顾性分析 (2011-2022年).
- 这些MRF包括功能障碍,肝功能障碍,TPN依赖,镇静剂,麻药,内药和机械通风.
- 基于VAD植入和移植的MRF数量的死亡率的比较.
主要成果:
- 在移植时,6名患者有≥3个MRF,17名患者有1-2个MRF,16名患者没有MRF.
- 移植时≥3个MRF的患者的医院死亡率为50%,而0-2个MRF的患者为0% (P=.01).
- 死亡率的独立预测因素包括麻,呼吸机使用,TPN依赖和功能障碍.
结论:
- 在儿科患者中,VADs有助于减少MRF.
- 在心脏移植时持续的MRF与明显更高的死亡率有关.
- 积极的移植前优化MRF对于改善VAD患者的移植后生存至关重要.
相关概念视频
Cardiomyopathy V: Interprofessional Care
17
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
17
Mitral Stenosis III: Medical Management
13
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
13
Mitral Regurgitation III: Medical Management
19
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
19
Heart Failure V: Medical Management
15
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
15
Aortic Regurgitation III: Medical Management
26
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
26
Cardiomyopathy IV: Restrictive Cardiomyopathy
12
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
12

