两个人的抽水:怀孕患者支持左心室辅助装置的怀孕
Daniel Oren1, Cathrine M Moeller1, Jennifer H Haythe1
1From the Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY.
概括
使用左心室辅助装置 (LVAD) 怀孕是可能的,尽管有风险. 在80%的审查病例中,成功分娩发生,强调多学科的护理来管理怀孕期间的风险.
科学领域:
- 心脏病学 心脏病学
- 生殖医学 生殖医学
- 关键护理医学 关键护理医学
背景情况:
- 左心室辅助器件 (LVAD) 对于晚期心力衰竭至关重要.
- 妇女占心力衰竭患者的很大一部分.
- 在LVAD患者的怀孕具有独特的孕产妇和胎儿风险.
研究的目的:
- 审查使用LVAD支持的妇女怀孕的挑战和结果.
- 确定成功怀孕的关键管理策略.
- 为考虑怀孕的LVAD患者提供共享决策的信息.
主要方法:
- 在LVAD支持的妇女中确认怀孕的文献综述.
- 分析母亲和胎儿的结果.
- 对血液动力学稳定性和安全性的管理策略的综合.
主要成果:
- 在LVAD支持期间发现了10例怀孕病例.
- 据报道,有8次成功分娩.
- 风险包括血液动力学压力,血栓形成,产性和子宫入.
结论:
- 怀孕在LVAD支持下是可以实现的,只要谨慎管理.
- 一种多学科的方法,优化抗凝剂和LVAD调整至关重要.
- 需要进一步的研究来支持患者的知情选择.
相关概念视频
Mitral Valve Prolapse III: Nursing Management
14
The nursing management of Mitral Valve Prolapse, or MVP, centers around patient education, symptom monitoring, and lifestyle modifications.Patient Education on MVP Diagnosis and Heredity: Nurses should provide comprehensive education about MVP, a condition where the mitral valve does not close appropriately during heartbeats. This education often includes the condition's pathophysiology, symptoms, and potential complications, like arrhythmias or mitral regurgitation. Though not fully...
14
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
Heart Failure VI: Adjunct Therapies
15
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
15
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 VII: Pre and Post Operative Nursing Management
15
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
15


