在患者中胃肠道出血的演变 连续流动左心室辅助器件支持的患者
Anh Nguyen1, Andrew Civitello2, Alexis Shafii1
1From the Division of Cardiothoracic Transplantation and Circulatory Support, Department of Surgery, Baylor College of Medicine, Houston, Texas.
概括
胃肠道出血在连续流动左心室辅助装置 (CF-LVAD) 患者中很常见,特别是50岁以上的患者. 与轴流模型相比,完全磁悬浮的设备显著降低了出血风险.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 胃肠病学 胃肠病学
背景情况:
- 胃肠道 (GI) 出血是患有连续流动左心室辅助器件 (CF-LVADs) 的患者的重大并发症.
- 了解风险因素对于管理这些患者至关重要.
研究的目的:
- 评估CF-LVAD接受者的胃肠道出血的特征和确定风险因素.
- 为了在不同类型的CF-LVAD中比较出血风险.
主要方法:
- 从2008-2023年对一个单一机构的Intermacs数据库进行分析.
- 包括1,030个CF-LVAD植入物.
- 用多变量考克斯比例危险回归来确定风险因素.
主要成果:
- 胃肠道出血发生在37.5%的患者中,再出血率为65.3%.
- 50岁以上的患者患胃肠道出血的风险增加了3.15倍.
- 与轴流动LVAD相比,完全磁悬浮的离心流动LVAD显示,肠道出血风险降低了四倍.
- 冠状动脉疾病和慢性病与增加肠道出血风险有关.
结论:
- 胃肠道出血是CF-LVAD患者经常发生的严重并发症.
- 患者的年龄,特定的LVAD类型,冠状动脉疾病和慢性病是关键的危险因素.
- 使用完全磁悬浮的离心流动LVAD可以减轻胃肠道出血的风险.
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