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多中心评估左心室辅助装置植入与或没有ECMO桥在心脏性休克的多中心评估

James W Schurr¹, Lara Ambrosi², Jillian Fitzgerald³

¹Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.

Artificial organs

|March 9, 2024

概括

作为桥梁到左心室辅助装置 (LVAD) 的体外膜氧化 (ECMO) 与较高的死亡率有关. 然而,与较旧的设备相比,当代的HeartMate 3 LVAD显示了改善的生存率和减少的血栓形成.

科学领域:

心脏病学心脏病学
心血管外科心血管外科
医疗器械医疗器械

背景情况:

外体膜氧化 (ECMO) 作为左心室辅助器件 (LVAD) 的桥梁的作用还不清楚.
当代HeartMate 3 (HM3) LVAD接收者在现有研究中代表性不足.

研究的目的:

评估ECMO作为LVAD植入器桥梁的疗效和结果.
为了比较ECMO和非ECMO桥接患者之间的结果.
评估LVAD类型对患者生存和并发症的影响.

主要方法:

这是一项多中心的回顾性研究,包括INTERMACS 1 LVAD接受者.
倾向加权生存分析,以比较ECMO和非ECMO组之间的死亡率.
记录住院和一年的结果,包括存活率,设备类型和并发症.

主要成果:

与ECMO桥接的患者死亡率更高 (HR 3.22,p=0.039) 和右心室辅助器件和缺血性中风的发生率增加.
与HeartMate II (HMII) 或HeartWare HVAD (46.9%与31.6%) 相比,HeartMate 3 (HM3) 接收者的一年死亡率明显较低 (10.5%).
一年后的血栓在HM3接受者 (1.8%) 与HMII或HVAD (16.1%与16.2%) 相比显著降低.

结论:

虽然ECMO与LVAD之间的桥梁与更高的死亡率有关,可能是由于患者的敏性,但与历史数据相比,一年生存率仍然可以接受.
HeartMate 3 LVAD与改善生存率和减少血栓形成有关,突出显示了机械循环支持装置的进步.

关键词:

在ECMO中,可以使用ECMO.在LVAD和LVAD之间.晚期心力衰竭是什么意思心脏发生的冲击是心脏性冲击.机械循环支持机械循环支持

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