在患有HeartMate 3的患者中,大动脉根性血栓形成,左心室辅助装置支持左心室辅助装置
Matthew R Carey1, Dylan Marshall2, Kevin Clerkin3
1Department of Internal Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY.
概括
大动脉根栓塞 (ART) 影响近10%的HeartMate 3患者. 动脉复合疗法增加了死亡,中风,大动脉干预和大动脉衰竭的风险.
科学领域:
- 心血管外科心血管外科
- 医疗器械 医疗器械
- 血栓形成研究研究
背景情况:
- 大动脉根栓塞 (ART) 是连续流动左心室辅助装置 (CF-LVAD) 治疗的已知并发症.
- 特别是在HeartMate 3 (HM3) 设备接受者中,ART的发生率和相关并发症以前没有被描述.
研究的目的:
- 为了确定在植入HeartMate 3 (HM3) 左心室辅助装置的患者中发生的大动脉根血栓形成 (ART) 的发生率.
- 在这个患者群体中调查与ART相关的并发症,包括大动脉功能衰竭和不良临床结果.
主要方法:
- 在2014年11月至2020年8月期间接受HM3设备的197名患者的回顾性审查.
- 分析了心声图和对比度增强的CT扫描,以确定ART和中度或较大的大动脉缺陷 (AI).
- 包括死亡,中风和大动脉干预措施在内的结果在接受和不接受ART的患者之间进行了比较.
主要成果:
- 在HM3患者中,ART的发病率为9.6% (19在197人中),平均随访时间为17.5个月.
- 治疗ART显著与死亡,中风或大动脉干预 (SHR 3.60) 和中度或更大的AI (SHR 11.1) 的复合终点风险增加有关.
- 与没有ART (0%) 患者相比,ART患者的甲状腺干预率 (26.3%) 较高,其中31.6%的ART患者患有中度或更大的AI.
结论:
- 通过HeartMate 3设备支持的近10%的患者发展出大动脉根凝血症.
- 在HM3接受者中,大动脉根栓塞与不良事件的更高风险有关,包括死亡,中风,大动脉干预和显著的大动脉功能不充分.
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