用Impella 5.x进行短期机械支持,用于在先进的心力衰竭保护心脏手术中进行心脏膜手术
Anja Osswald1, Sharaf-Eldin Shehada1, Alina Zubarevich1
1Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Duisburg-Essen, Essen, Germany.
Frontiers in cardiovascular medicine
|August 7, 2023
概括
在患有晚期心力衰竭的患者中,Impella 5.x 短期机械循环支持 (st-MCS) 是高风险的中心手术的安全和有效方法. 这种方法证明了可行性和出色的结果,为复杂的案件提供了可行的替代方案.
科学领域:
- 心血管外科心血管外科
- 干预心脏病学 干预心脏病学
- 心脏衰竭管理的管理
背景情况:
- 在晚期心力衰竭中,手术治疗额头骨反 (MR) 是具有挑战性的.
- 在这些患者中,外科手术期间心脏输出低是显著的风险.
- 短期机械循环支持 (st-MCS) 可以减轻这些风险.
研究的目的:
- 评估使用Impella 5.x (st-MCS) 在高风险的中膜手术中的安全性和可行性.
- 为了评估MR和先进心力衰竭患者在Impela支持下接受手术的结果.
- 确定这种策略是否适用于无法接受过导管端到端修复 (TEER) 或需要同时进行手术的患者.
主要方法:
- 对11名连续接受了米特拉手术的高风险患者的回顾性分析 (2017年7月至2022年4月).
- 所有患者都接受了手术前的Impella 5.x支持.
- 进行了心心门的修复或更换,一些患者接受了同时的手术.
主要成果:
- 患者平均年龄为61.6岁,MR是由于缺血性或扩张性心肌病变的 (平均射出分数为21%).
- 除了一名患者外,所有患者都成功地停止使用Impella支持 (平均支持持续时间为8天).
- 没有观察到与Impella相关的并发症,30天生存率为90.9%.
结论:
- 使用Impella 5.x st-MCS进行心脏保护手术是安全的,并且在高风险的中枢手术中是可行的.
- 这一策略带来了优秀的结果,没有 st-MCS 相关的并发症.
- 它为患有晚期心力衰竭的MR患者提供了全面的方法,特别是那些不符合TEER或需要额外手术的患者.
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