在患有连续流动左心室辅助装置的患者中,同时进行大动脉修复的中期结果
Melissa A Hynds1, Hideyuki Hayashi1, Paul Kurlansky2
1Division of Cardiac, Thoracic & Vascular Surgery, Department of Surgery, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, New York, NY.
The Journal of thoracic and cardiovascular surgery
|May 27, 2024
概括
中枢大动脉的修复有效地减轻了接受HeartMate II或3左心室辅助器件的患者的大动脉缺陷. 这种技术在治疗这种并发症方面显示出有希望的结果,提高了患者的治疗结果.
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 医疗器械
背景情况:
- 大动脉衰竭是左心室辅助装置 (LVAD) 植入后的潜在并发症.
- 连续流动的LVAD,如HeartMate II和3,对于高级心力衰竭管理至关重要.
- 优化大动脉的功能对于LVAD的性能和患者的生存至关重要.
研究的目的:
- 评估中央大动脉门修复在接受LVAD植入的患者中预防或减轻大动脉缺陷的疗效.
- 分析大动脉衰竭的发病率和严重程度后LVAD与同时发生的大动脉门修复.
- 评估与这种联合手术方法相关的长期结果.
主要方法:
- 在2004年至2022年期间植入HeartMate II或3个LVAD的患者的回顾性评估.
- 排除之前有过大动脉门手术,双大动脉门或基线痕迹大动脉不全的患者.
- 包括患有轻度或较大的大动脉衰竭并同时接受中央大动脉修复的患者.
主要成果:
- 105名患者符合研究标准 (59名HeartMate II,46名HeartMate 3).
- 没有中度或较大的大动脉衰竭的高率为96.4%在1年,93.3%在2年和91.0%在3年.
- 住院死亡率为5.7%,3年生存率为63.4%.
结论:
- 中央大动脉的修复似乎是一个有效的策略,以管理与HeartMate II和3LVADs患者的大动脉功能不充分.
- 这种方法可以通过预防或减少大动脉反的严重性来改善结果.
- 建议对更大的队列进行进一步调查,并进行更长的随访,以证实这些发现.
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