四种设备,一种解决方案:金心脏再同步疗法与除器在一个病人与过敏过敏
Rahul Devathu1, Kushal Chatterjee1, Erick Godinez2
1Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
概括
过敏可以导致CIED并发症. 一个定制的金设备在多次设备故障后成功管理了一名患者,改善了心脏功能.
科学领域:
- 心脏病学 心脏病学
- 生物材料科学 生物材料科学
- 过敏和免疫学 过敏和免疫学
背景情况:
- 过敏是心脏植入式电子设备 (CIED) 患者罕见但重要的并发症原因.
- 对的反应可以模仿设备感染,导致错误诊断和重复的设备爆炸.
- 尽管具有一般的生物相容性,但患者的特定敏感性会给临床带来挑战.
研究的目的:
- 报告一个由于过敏导致的CIED复发症患者的成功管理情况.
- 突出在CIED患者中诊断和管理过敏的挑战.
- 为了证明替代设备材料在耐火情况下的实用性.
主要方法:
- 一名67岁的男性患有非缺血性心肌病,由于对过敏而经历了多次CIED失败.
- 以前使用高尔-德克斯包装的尝试在缓解过敏方面没有成功.
- 根据FDA的同情使用条款,植入了一种定制的金心脏再同步治疗与除器 (CRT-D) 设备.
主要成果:
- 患者通过右侧方法获得金的CRT-D.
- 在一年的随访中,手术部位愈合良好,没有复发的并发症或不适.
- 左心室喷射分数 (LVEF) 显著改善,从植入后的29%提高到50%.
结论:
- 这一案例凸显了与CIED接受者的过敏相关的诊断困难.
- 对于过敏的传统管理策略可能是有限的.
- 跨学科的合作对于导航监管途径和提供特定的患者,使用替代材料提供持久的解决方案至关重要.
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