输出输入栓塞:一个未被认可的阻塞原因
Estefania Oliveros1, Arjun Gupta2, Kiran Mahmood2
1Lewis Katz School of Medicine, Temple University Hospital, Philadelphia, PA.
Journal of cardiothoracic and vascular anesthesia
|September 12, 2024
概括
输出输入塞是左心室辅助器件 (LVAD) 的已知的并发症. 及时诊断和干预,包括手术或皮肤穿刺方法,可以恢复LVAD功能并改善患者的治疗结果.
科学领域:
- 心血管外科心血管外科
- 医疗器械 医疗器械
- 心脏衰竭管理的管理
背景情况:
- 左心室辅助器件 (LVAD) 输出流的移植阻塞会导致严重的临床衰退.
- 外部压缩引起的外流移植吸管是一种未被认可的阻塞机制.
- 对LVAD输出流的管理策略缺乏标准化.
研究的目的:
- 报告使用LVAD的单中心体验外流移植坦波纳.
- 为这种并发症开发一个最佳的诊断和治疗算法.
主要方法:
- 从2011年7月到2020年7月,对LVAD患者的回顾性图表审查.
- 识别患有外流移植坦波纳的患者.
- 对临床表现,器械类型和管理结果的分析.
主要成果:
- 在351名LVAD患者中,在26名患者中发现了外流移植坦波纳.
- 患者在平均862天后出现心力衰竭症状,声和LVAD报警.
- 干预措施包括小型胸切除术 (n=15),皮肤穿透气球扩张/支架 (n=4),以及桥梁移植 (n=2).
结论:
- 输出输入移植坦波纳德是LVAD输出输入移植阻塞的独特形式.
- 它呈现的变化很大,并可能导致显著的血液动力学损害.
- 无论是外科手术还是皮肤间的干预都有效地恢复了LVAD功能.
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