在植入持久左心室辅助装置后发生的血栓栓塞并发症
Bratislavske lekarske listy
|May 17, 2024
概括
血栓栓塞并发症,特别是血栓塞,是第二代连续流动左心室辅助器件 (CF-LVADs) 的常见情况. 第三代设备的发病率较低,早期心脏移植的血栓溶解是一种可行的治疗方法.
科学领域:
- 心血管外科心血管外科
- 医疗器械 医疗器械
- 血栓形成研究研究
背景情况:
- 左心室辅助装置 (LVAD) 的使用正在增加,导致更多的长期幸存者.
- 这种LVAD使用量的增加与不良事件的发生率较高有关,特别是血栓栓塞并发症.
- 评估这些并发症的风险对于患者管理至关重要.
研究的目的:
- 评估长期连续流动左心室辅助装置 (CF-LVAD) 植入后血栓栓塞并发症的发生率和结果.
- 为了比较不同CF-LVAD模型之间的并发症率.
- 评估血栓症治疗策略的有效性.
主要方法:
- 在2007年至2022年期间接受CF-LVAD (HeartMate II,HeartMate 3,Heart Ware) 的169名患者的回顾性分析.
- 数据是从EUROMACS注册表中提取的.
- 分析了患者人口统计,设备类型,并发症事件和管理策略.
主要成果:
- 血栓栓塞并发症 (血栓症) 在6.5%的患者中发生 (11/169).
- 与HeartMate II (1/11例) 相比,Heart Ware设备与更高的发病率 (10/11例) 相关.
- 治疗包括血栓溶解,抗凝,交换/移植或早期心脏移植,受影响患者的死亡率为36.4%.
结论:
- 血栓塞栓并发症,主要是血栓塞,在第二代CF-LVAD中相对常见,但在第三代设备中很少见.
- 血栓溶解之后的早期心脏移植是一种安全有效的治疗选择.
- 设备生成显著影响血栓栓塞事件的风险.
相关概念视频
Cardiac Catheterization II: Right Heart Catheterization
2.2K
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...
2.2K
Cardiac Catheterization III: Left Heart Catheterization
1.3K
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...
1.3K
Cardiomyopathy II: Dilated Cardiomyopathy
798
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,...
798
Cardiomyopathy V: Interprofessional Care
761
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...
761
Venous Thrombosis III: Interprofessional Care
482
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
482
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
760
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
760


