左心室辅助器件患者的大动脉吐:大动脉根扩张是否导致门无能?
Gloria Färber1, Ulrich Schneider1, Stephanie Gräger2
1Department of Cardiac Surgery, Saarland University Medical Center, Homburg/Saar, Germany.
Artificial organs
|September 30, 2024
概括
在HeartMate 3左心室辅助装置 (LVAD) 植入后的大动脉反 (AR) 影响3年内三分之一的患者. 这种并发症与大动脉根或圆扩张无关.
科学领域:
- 心血管医学 心血管医学
- 医疗器械 医疗器械
- 心脏外科手术 心脏外科手术
背景情况:
- 大动脉反 (AR) 是左心室辅助装置 (LVAD) 植入后的一个已知的并发症.
- 复发性心力衰竭可能导致复发性心力衰竭,潜在的病理机制包括膜问题和大动脉根扩张.
- 这项研究的重点是评估与HeartMate 3 LVAD植入患者的大动脉根尺寸.
研究的目的:
- 在接受HeartMate 3 LVAD的患者中评估大动脉反 (AR) 的发生率和进展.
- 为了评估这些患者随着时间的推移而发生的大动脉根尺寸 (环,鼻,鼻管结) 的变化.
- 为了将AR发展和大动脉根尺寸与临床结果相关联,包括生存率.
主要方法:
- 一组68名在HeartMate 3植入时没有或轻度AR的患者被追溯确定.
- 进行了序列心声扫描,以监测AR严重程度和大动脉根尺寸.
- 随访时间中位数为40个月,结果与临床结果和生存率相关.
主要成果:
- 在随访期间,34%的患者发展了II级或更高的AR,五年精算发生率为41%.
- 大动脉根尺寸 (环,鼻,鼻管结) 与手术前测量相比保持稳定,无论AR的发展如何.
- 五年生存率为71%,在具有和没有显著AR的患者之间没有显著差异.
结论:
- 随着时间的推移,中度或重度的大动脉反会在相当大比例的HeartMate 3 LVAD接受者中发展.
- 在这个队列中AR的发展似乎与大动脉环或根的逐渐扩张无关.
- 对LVAD后AR的特定机制进行进一步的研究是有必要的.
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