在不太侵入性左心室辅助装置植入后,右心室收缩和肺动脉合.
George Adly1, Oliver Mithoefer1, John Elliott Epps1
1From the Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina.
ASAIO journal (American Society for Artificial Internal Organs : 1992)
|October 10, 2023
概括
在左心室辅助装置植入时,一种不那么侵入性的策略 (LIS) 可以保持右心室 (RV) 收缩性,并改善RV-肺动脉合,而不是与传统的中枢胸切除术 (CMS) 相比. 这一发现表明,LIS可能会减少植入后的RV衰竭.
科学领域:
- 心血管外科心血管外科
- 心脏生理学 心脏生理学
- 医疗器械技术 医疗器械技术
背景情况:
- 右心室 (RV) 衰竭是左心室辅助器件 (LVAD) 植入后的一个主要并发症.
- 传统的中侧骨切除术 (CMS) 和少入侵的策略 (LIS) 是LVAD植入的手术方法.
- 对CMS与LIS对RV收缩性和RV-肺动脉 (RV-PA) 合的影响尚不清楚.
研究的目的:
- 调查LIS与CMS对LVAD植入后负载独立RV收缩性和RV-PA合性的影响.
- 与CMS相比,测试LIS保留RV收缩性并改善RV-PA合的假设.
主要方法:
- 对接受持久离心LVAD植入的患者进行回顾性研究,植入前和后进行血液动力学评估.
- 使用数字化RV压力波形,确定RV收缩性 (末缩弹性[Ees]) 和RV后负荷 (肺有效动脉弹性[Ea]).
- 计算RV-PA合作为Ees/Ea的比率.
主要成果:
- 在CMS和LIS组之间,在植入前的Ees,Ea或Ees/Ea没有显著差异.
- 在植入后,Ees在CMS组显著下降,但在LIS组保持稳定.
- 在CMS组,RV-PA合 (Ees/Ea) 保持不变,但在LIS组显著改善.
结论:
- 与CMS相比,LIS LVAD植入可能更好地保持RV收缩性.
- 与CMS相比,LIS方法似乎可以改善LVAD植入后的RV-PA合.
- 这些发现表明,LVAD植入后,LIS可能与更好的VR功能结果有关.
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