动力线转移和真空辅助关闭对于心室辅助装置的动力线感染
Mehmet Cahit Saricaoglu1, Melisa Kandemir1, Elif M Saricaoglu2
1Department of Cardiovascular Surgery, Heart Center, Cebeci Hospitals, Ankara University School of Medicine, Dikimevi, Ankara 06340, Turkey.
Journal of cardiovascular development and disease
|June 25, 2025
概括
在心室辅助器件 (VAD) 植入后,驱动线感染 (DLI) 是常见的. 包括DL搬迁和真空辅助关闭 (VAC) 在内的外科管理可以帮助控制这些严重的VAD并发症.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 手术创新 在外科创新.
背景情况:
- 持久的机械循环支持 (DMCS) 感染,特别是腹腔辅助装置 (VAD) 特定的驱动线感染 (DLI),带来了重大挑战.
- 对DLI的外科治疗缺乏明确的共识,这凸显了患者护理中的关键差距.
研究的目的:
- 确定VAD患者中DLI的发病率,风险因素和微生物学.
- 讨论和评估VAD驱动线感染的外科治疗方式.
主要方法:
- 在2011年3月至2023年5月期间接受LVAD或BiVAD植入的90名患者的回顾性审查.
- 分析VAD类型 (HeartMate 2,HeartWare HVAD,HeartMate 3) 和患者数据,以确定DLI风险因素和结果.
主要成果:
- DLI发生在21.5%的患者中,晚发 DLI的发病率较高,与更长的 VAD 支持持续时间相关 (p < 0.05).
- DLI风险的独立预测因素包括年轻年龄 (HR 9.77) 和较低的血白蛋白水平 (HR 10.55).
- 在9名患者中,使用了诸如生物膜去除,通过直肠肌肉转移驱动线和真空辅助关闭 (VAC) 等手术干预,其中1名患者患有复发性感染,1名患者患有DLI后心脏移植.
结论:
- DLI是VAD植入的频繁和严重并发症,影响患者的自主权,生活质量和生存.
- 驱动线转移和VAC策略在有效管理DLI方面显示出希望.
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