Impella 5.5 支持延迟的外科手术心室隔膜缺陷修复 - 一个范式转变?
Kaveh Eghbalzadeh1,2, Clara Großmann1,3, Ihor Krasivskyi1,2
1Department of Cardiothoracic surgery, Heart Center Cologne, Cologne, Germany.
The Thoracic and cardiovascular surgeon
|August 12, 2024
概括
在高风险患者中,用于修复心室隔膜缺陷 (VSD) 的手术前Impella 5.5支持是安全的和可行的. 这种机械循环支持可能会改善结果,当VSD修复被推迟用于组织稳定时.
科学领域:
- 心血管外科心血管外科
- 干预心脏病学 干预心脏病学
- 机械循环支持 机械循环支持
背景情况:
- 心室隔膜缺陷 (VSDs) 是一种罕见的,危及生命的心肌梗塞并发症,死亡率高.
- 机械循环支持 (MCS) 对于VSD修复的研究不足,Impella经常被认为是禁忌的.
- 及时修复VSD至关重要,但延迟干预可能有利于组织稳定.
研究的目的:
- 评估使用Impella 5.5作为接受VSD修复的患者的主要机械循环支持的安全性和可行性.
- 分析在手术修复前接受Impella 5.5支持的VSD患者的结局.
主要方法:
- 在Impella 5.5植入后,四名连续患有VSD的患者进行了延迟的手术修复后的回顾性分析.
- 收集了关于患者表现,Impella植入程序和术后过程的数据.
主要成果:
- 75%的患者出现了急性右心力衰竭和肺动脉压力升高.
- 在大多数情况下,Impella 5.5植入在局部麻醉下进行.
- 在75%的患者中,Impella 5.5的成功断奶发生在75%的患者中,重症监护室平均停留时间为22.3天.
结论:
- 术前的Impella 5.5植入是VSD修复患者的安全和可行的选择.
- 局部麻醉和持续的Impella支持可改善治疗后的结果.
- 尽管有潜在的益处,VSD患者仍然存在高风险,死亡率很高.
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