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在接受HeartMate 3左心室辅助装置植入的患者中同时进行心脏外科手术
The Israel Medical Association journal : IMAJ
|May 13, 2024
概括
在HeartMate 3 (HM3) 左心室辅助装置 (LVAD) 植入期间同时进行心脏外科手术的死亡率与单独使用HM3-LVAD相比相似. 这项研究发现,在接受两种手术的患者中,30天,6个月或12个月的生存时间没有显著差异.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 机械循环支持 机械循环支持
背景情况:
- 使用HeartMate 3 (HM3) 左心室辅助装置 (LVAD) 的长期支持改善了末期心力衰竭的结果.
- 关于在HM3-LVAD植入过程中接受并发心脏外科手术 (CCSP) 的患者的结果,数据有限.
研究的目的:
- 为了评估在HM3-LVAD植入过程中CCSP的单中心经验.
- 为了比较接受HM3-LVAD与CCSP治疗的患者和仅接受HM3-LVAD治疗的患者之间的结果.
主要方法:
- 一项对131名在2016年12月至2022年4月期间接受HM3-LVAD植入的成年患者的回顾性审查.
- 23名患者接受了HM3-LVAD植入与CCSP (HM3+CCSP),而108名患者仅接受了HM3-LVAD植入 (仅HM3).
- 同时的手术包括门维修/更换,隔膜缺陷关闭等.
主要成果:
- 与HM3+CCSP组相比,HM3+CCSP组的心肺绕道时间平均较长 (155±47分钟),而仅HM3组的时间较长 (113±58分钟) (P=0.007).
- 在HM3+CCSP组 (9%,22%,26%) 和仅HM3组 (6%,17%,28%) 之间,30天,6个月和12个月的死亡率没有显著差异.
- 在任何时间点都没有观察到死亡率的统计学上显著差异 (P = 0.658,0.554,1.000).
结论:
- 在HM3-LVAD植入期间同时进行心脏外科手术不会显著影响短期或中期死亡率.
- 与CCSP一起进行HM3-LVAD植入的患者的生存结果与仅接受HM3-LVAD的患者相似.
- 这表明,结合手术可能是选择心力衰竭患者的安全选择.
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