冠状动脉鼻减小器患者的心脏再同步治疗:一个案例系列
Christian Grebmer1, Matthias Bossard1, Adrian Attinger-Toller1
1Department of Cardiology, Heart Center Lucerne, Luzerner Kantonsspital, Spitalstrasse 16, 6002 Luzern, Switzerland.
European heart journal. Case reports
|September 25, 2023
概括
心脏再同步治疗 (CRT) 在患有冠状动脉鼻减小器 (CSR) 系统的患者中是可行的. 在CSR植入后的提取是可能的,但存在风险,需要仔细考虑替代方案.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗器械 医疗器械
背景情况:
- 耐火性心痛可以通过使用冠状 sinus 减轻器 (CSR) 系统来减少冠状 sinus 静脉排水来治疗.
- 心脏再同步疗法 (CRT) 是心力衰竭的标准治疗方法,其左心室功能受损和失同步.
- 关于CSR和CRT的联合使用的数据有限.
研究的目的:
- 介绍第一个案例系列,评估CRT在先前植入CSR系统的患者中的可行性.
- 报告该患者队列中CRT植入和随后手术的结果.
主要方法:
- 使用案例序列方法,描述了三名患有耐火性心痛和心力衰竭的患者,在CSR系统安置后接受CRT植入.
- 该研究记录了CRT程序的可行性,并评估了结果,包括在一个案例中提取.
主要成果:
- 在所有三名具有CSR系统的患者中,CRT植入是可行的.
- 在CSR植入后的左心室取成功地在一名患者身上进行,尽管它突出了与粘附相关的潜在风险.
- 在患有复杂病史的患者中,CSR系统植入是可行的,没有重大并发症.
结论:
- 对于具有CSR系统的患者来说,CRT是一种可行的治疗选择.
- 虽然提取后的CSR是可能的,但显著的粘附带有很高的并发症风险,这表明早期讨论替代策略至关重要.
相关概念视频
Cardiomyopathy II: Dilated Cardiomyopathy
11
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
11
Cardiomyopathy V: Interprofessional Care
14
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...
14
Dysrhythmias VI: Management of Dysrhythmias
19
Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
19
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
Cardiomyopathy III: Hypertrophic Cardiomyopathy
16
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
16
Mitral Stenosis III: Medical Management
12
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...
12


