在成年人中植入血液动力学监测的新型用途,这些成年人患有下右心室
William H Marshall V1,2, May Ling Mah2, Jennifer DeSalvo3
1Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA william.marshall@osumc.edu.
Heart (British Cardiac Society)
|November 7, 2023
概括
可植入的侵入性血液动力学监测 (IHM) 在患有右心室 (sRV) 的患者中提供了新的用途,可能减少重复导管的需要. 这项技术在研究队列中对心力衰竭住院的病例没有显著影响.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 遗传性心脏病是一种先天性心脏病.
背景情况:
- 肺高血压 (PH) 是患有大动脉 (TGA) 在心房切换 (D-TGA / AS) 和先天纠正的TGA (ccTGA) 后的大动脉 (TGA) 的dextro转移患者的常见并发症.
- 心声图是不靠谱的查工具PH在患者下道右心室 (sRV).
- 植入式侵入性血液动力学监测 (IHM) 在这种人群中为PH查和管理提供了潜在的替代方案,尽管数据有限.
研究的目的:
- 报告IHM在sRV.成年患者中的新型应用.
- 评估IHM对心力衰竭住院治疗 (HFH) 的影响.
- 在这个患者群体中评估与IHM相关的设备相关并发症.
主要方法:
- 从2015年到2022年在一个单一中心进行的回顾性研究.
- 包括接受IHM的sRV的成年患者.
- 对IHM利用率,HFH率和设备并发症的分析.
主要成果:
- 在18名sRV患者 (平均年龄43岁;16名D-TGA/AS,2名ccTGA) 中植入了IHM,其中13名在导管注射后出现了PH.
- IHM用于医疗疗法定位,移植限定的PH中心室后辅助器件管理和连续的肺动脉压力监测.
- 随访时间中位数为23个月;HFHs/年在IHM前后保持相似 (中位数为0.0对0.0,p=0.984).
- 一个设备迁移的案例发生在没有长期后果的情况下.
结论:
- 在sRV患者中证明了IHM的新用途,这可能会在PH流行的人群中最大限度地减少对串行导管注射的需求.
- IHM并没有显著改变心力衰竭住院率.
- 这项研究强调了IHM在治疗具有sRV的复杂先天性心脏病患者中的安全性和实用性.
更多相关视频
相关概念视频
Cardiac Catheterization II: Right Heart Catheterization
25
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...
25
Pulse rhythm
812
Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
812
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 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
Holter Monitor: 24-Hour Monitoring
22
Holter monitoring is a continuous electrocardiography (ECG) recording that tracks the heart's electrical activity over an extended period, generally 24 to 48 hours. This noninvasive diagnostic tool detects irregular heart rhythms that may not be captured during a standard ECG performed in a clinical setting.DeviceThe Holter monitor is a portable, small device connected to several electrodes on the patient's chest. These electrodes detect the heart's electrical signals and transmit them to the...
22


