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相关概念视频

Cardiomyopathy V: Interprofessional Care01:29

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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...
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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...
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Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
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Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
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在插入HeartMate 3后,侧向方法是否能保持右心室功能?

Hideyuki Hayashi1, Michael Kirschner1, Alice Vinogradsky1

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概括

侧侧胸切除术 (LT) 方法在左心室辅助装置 (LVAD) 植入后显示出更好的短期右心室 (RV) 功能. 然而,长期存活率和不良事件发生率在LT和胸腔切除术之间是相似的.

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科学领域:

  • 心脏病学 心脏病学
  • 心脏外科手术 心脏外科手术
  • 医疗器械 医疗器械

背景情况:

  • 左心室辅助装置 (LVAD) 植入是晚期心力衰竭的关键治疗方法.
  • 选择外科手术方法,如侧侧胸切除术 (LT) 或中侧胸切除术,可能会影响植入后的右心室 (RV) 功能.
  • 维护RV功能对于LVAD手术后的患者结果至关重要.

研究的目的:

  • 为了评估和比较LT与中枢骨管切除在HeartMate 3 LVAD植入后对VR功能的短期和长期影响.
  • 评估手术方法对RV几何和缩功能的影响,使用心声回声学.
  • 确定手术方法是否会影响长期结果,包括死亡率和VR失效相关事件.

主要方法:

  • 对接受HeartMate 3 LVAD的195名患者进行了回顾性审查.
  • 根据外科手术方法,患者被分为两组:LT (n=55) 和中枢椎切除 (n=140).
  • 在手术前,在1个月后和在植入后1年后,对VR功能进行了心声评估. 主要结局是全因死亡率;次要结局是死亡或RV故障再入院的复合结果.

主要成果:

  • 在手术前的RV几何或功能中,在LT和胸腔切除组之间没有观察到显著的差异.
  • 在LVAD植入后一个月,LT组表现出显著更好的VR功能,由较小的VR尺寸和改善的分数面积变化和峰值缩速度证明.
  • 尽管LT治疗改善了短期RV功能,但Kaplan-Meier分析显示,两种手术方法之间的2年生存率 (93%vs. 83%) 或不良事件率 (76%vs. 71%) 之间没有显著差异.

结论:

  • 侧侧胸切除术方法与左心室辅助装置植入后一个月内更好地保留右心室功能有关.
  • 然而,这种短期的功能益处并没有转化为长期存活率或不良事件率的显著差异,而不是与中位子椎切除方法相比.
  • 这些发现表明,虽然LT可能在早期RV恢复中提供优势,但对长期结果的整体临床影响需要进一步研究.