重复左心室辅助设备交换和升级从第二到第三代设备在一个大容量单一中心
Mahwash Kassi1, Eleonora Avenatti1, Khanh-Doan Hoang2
1Department of Cardiology, Houston Methodist Hospital - DeBakey Heart and Vascular Center, Houston, Texas, USA.
Artificial organs
|January 8, 2024
概括
对于需要先进的机械循环支持的患者来说,重复HeartMate III (HMIII) 交换是可行的和安全的. 这种重复手术方法在专家中心的高风险个体中提供了良好的中期结果.
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
- 医疗器械技术 医疗器械技术
背景情况:
- 左心室辅助装置 (LVAD) 交换治疗血栓和感染等并发症.
- 升级到新一代LVAD可以为患者提供长期支持.
- 用第三代升级重复更换LVAD的安全性和有效性没有报告.
研究的目的:
- 评估反复更换LVAD和升级到第三代HeartMate III (HMIII) 的可行性和安全性.
主要方法:
- 对接受重复LVAD更换和升级到HMIII的患者的回顾性分析.
- 研究期:2018年12月至2020年12月,在休斯顿卫理医院进行.
- 在所有病例中都涉及心肺旁路的重复中枢硬膜切除术.
主要成果:
- 五名高风险患者进行了交换和升级到HMIII.
- 住院死亡率为20%;在出院患者的1,3和6个月随访期间,没有与LVAD相关的重大不良事件.
- 在所有出院患者中取得成功的HMIII支持.
结论:
- 重复换与HMIII升级是可行的和安全的在一个大体积的中心.
- 在专家手中,重整手术方法在中期提供了良好的结果.
- 治疗决策需要个性化风险评估和临床稳定性评估.
相关概念视频
Cardiac Catheterization II: Right Heart Catheterization
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...
Cardiac Catheterization III: Left Heart Catheterization
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...
Mitral Regurgitation III: Medical Management
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
Heart Failure VI: Adjunct Therapies
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.
Cardiomyopathy II: Dilated Cardiomyopathy
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,...
Cardiomyopathy V: Interprofessional Care
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...


