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安全实践:左心室辅助装置的部分覆盖可以在心脏移植过程中降低出血风险,而不会造成阻塞
Chen Chia Wang1, John Trahanas2, Mark Petrovic1
1Vanderbilt University School of Medicine, Nashville, TN.
概括
在HeartMate 3植入器中使用部分聚四乙烯 (PTFE) 可以减少心脏移植过程中的血液损失. 这种技术可以减轻出血风险,而不会造成外流移植阻塞.
科学领域:
- 心血管外科
- 移植医学
- 医疗设备工程
背景情况:
- 在心脏移植 (HT) 期间使用左心室辅助器件 (LVAD) 带来了手术上的挑战,特别是在手术期间和手术后出现显著的血液损失.
- 管理出血并发症对于改善患者在LVAD扩张和HT手术后的结果至关重要.
研究的目的:
- 评估在HeartMate 3植入过程中部分聚四乙烯 (PTFE) 保护覆盖对随后的显微体HT期间外科手术期间流血的影响.
- 确定这种技术是否可以减少输血需求和胸管输出.
主要方法:
- 一个单一机构的研究分析了接受HeartMate 3植入的患者的数据.
- 评估PTFE部分覆盖外流移植体和底盘与外科手术期间流失的相关性.
- 统计分析调整以考虑先前的胸腔切除和多器官移植等混因素.
主要成果:
- 在HeartMate 3植入过程中,部分PTFE覆盖与手术内和术后输血需求的显著减少有关.
- 有部分PTFE覆盖的患者也显示术后胸腔输出量显著降低.
- 在调整了先前的宫切除和多器官移植后,保护作用仍然显著.
结论:
- 在HeartMate 3植入过程中,部分PTFE保护是一种可行的策略,可以减轻外科手术期间的血液流失.
- 这种技术似乎可以减少出血并发症,而不会增加外流移植阻塞的风险,与完整的PTFE包裹不同.
- 标准化LVAD植入技术可以增强护理连续性,并简化扩展器-HT过程.
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