超过100名Fontan患者在系统性心室辅助器件支持:一个行动更新
Sharon Chen1, Kathleen E Simpson2,
1From the Division of Pediatric Cardiology, Lucile Packard Children's Hospital at Stanford University, Palo Alto, California.
概括
心室辅助装置 (VAD) 的支持为失败的Fontan循环提供了生命线. 尽管有高危患者和不良事件,但大多数患者在12个月内存活或接受移植.
科学领域:
- 心脏病学 心脏病学
- 儿童心脏病学 儿童心脏病学
- 机械循环支持 机械循环支持
背景情况:
- 方丹循环对心室辅助器件 (VAD) 的支持提出了独特的挑战.
- 随着Fontan人口的不断增长,需要了解VAD在这个群体中的有效性.
- 系统性VAD是Fontan患者末期心力衰竭的关键选择.
研究的目的:
- 分析Fontan循环患者系统VAD支持的结果.
- 为了确定随着时间的推移,Fontan患者的VAD植入的趋势.
- 在这个高风险人群中评估生存率和不良事件.
主要方法:
- 从ACTION注册表 (2012-2022) 获得VAD支持的106名Fontan患者的回顾性分析.
- 利用竞争结果和卡普兰-梅尔生存分析.
- 检查了患者的特征,VAD支持的持续时间和植入后的结果.
主要成果:
- 自2018年以来植入的患者更生病 (更高的INTERMACS配置文件) 和更多的内变异物.
- 中位数VAD支持持续时间为113天.
- 在12个月后,53%的人被移植,27%的人在装置上活着,18%的人已经死亡.
- 常见的不良事件包括出血,感染和神经功能障碍 (75%的人至少有一次).
结论:
- 在不断增长的Fontan人群中,系统VAD支持是可行的,即使在重症患者中也是如此.
- 尽管高敏度和不良事件,Fontan患者支持VADs显示有希望的12个月移植或生存率.
- 进一步研究优化VAD管理在Fontan生理学是有必要的.
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