持久的左心室辅助装置在微轴流动上的临时循环支持后,有或没有体外生命支持
Daniel Lewin1,2, Sebastian V Rojas3, Michael Billion4
1Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité, Berlin, Germany.
JTCVS open
|November 13, 2024
概括
这项研究评估了使用微轴流 (mAFP) 的临时机械循环支持 (tMCS) 后的耐用左心室辅助装置 (dLVAD) 结果. 开发了一个风险评分来预测1年死亡率,帮助患者选择dLVAD植入物.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 机械循环支持 机械循环支持
背景情况:
- 导管式微轴流量 (mAFP) 对于治疗严重心脏性休克至关重要.
- 耐用左心室辅助装置 (dLVAD) 是暂时机械循环支持 (tMCS) 后不符合心脏移植条件的患者的可靠选择.
- 这项研究调查了mAFP支持后的dLVAD治疗结果.
研究的目的:
- 在mAFP支持后描述dLVAD治疗的结果.
- 为了确定接受dLVADs后mAFP的患者死亡率的预测因素.
- 开发一个风险评分,以优化dLVAD植入患者的选择.
主要方法:
- 来自19个欧洲中心的多中心注册表 (n=332) 的回顾性分析.
- 纳入标准:在使用mAFP进行tMCS后接受dLVAD植入的患者 (2017年1月 - 2022年10月).
- 在mAFP设备 (Impella 5.5,5.0,CP),dLVAD (HeartWare HVAD,Heartmate 3) 和并发的体外生命支持上收集的数据.
主要成果:
- 30天和1年的生存率分别为87.8%和71.1%.
- 确定的1年死亡率的风险因素包括:年龄较大 (>55岁),肥胖 (BMI>30 kg/m2),女性性别,总 bilirubin 升高,血小板数低.
- 根据这些已识别的因素计算出一个风险得分.
结论:
- 风险评分可以有效估计dLVAD植入后的一年死亡率.
- 优化dLVAD患者选择对于改善结果至关重要.
- 这种风险评分有助于更好地管理心脏性休克治疗途径中的患者.
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