在没有抗凝固的 HeartWareTM HVAD 支持
Mats Steffi Jennifer Masilamani1, Emily Greengard2,3, Jonathan Nicholas Johnson1
1Division of Pediatric Cardiology/Department of Pediatrics and Adolescent Medicine, Mayo Clinic Children's, 200, 1 st St SW, Rochester, MN 55905 USA.
Indian journal of thoracic and cardiovascular surgery
|February 12, 2026
概括
这项案例研究显示,一个患有HeartWareTM左心室辅助装置 (HVAD) 的儿科患者在没有抗凝药的情况下成功管理了110天. 仔细的监测使得持续的支持成为可能,突出显示了VADs的不断发展的抗血栓策略.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 心血管外科心血管外科
- 在瘤学瘤学.
背景情况:
- 对于儿科心脏移植 (HTx) 候选人来说,心室辅助器件 (VAD) 是至关重要的,可以降低死亡率.
- 人类循环素诱导的心肌病 (AC) 在儿童癌症患者中可能导致急性静心性心力衰竭.
研究的目的:
- 报告一个独特的儿科病人的病例,使用HeartWareTM左心室辅助装置 (HVAD) 没有抗凝药进行管理.
- 突出在复杂情况下提供持久的HVAD支持的可行性,并进行仔细的监测.
- 讨论在VAD患者中不断发展的抗血栓策略.
主要方法:
- 一个案例报告,一个8岁的女孩患有骨髓瘤和AC需要HVAD植入.
- 治疗包括停止抗凝血和抗血小板药物治疗,原因是耐火性表和血小板狭窄.
- 长期随访包括监测并发症和最终的心脏移植.
主要成果:
- 患者在21个月内接受了持久的HVAD支持,没有抗凝或抗血小板治疗.
- 她从骨髓瘤中实现了缓解,并成功接受了心脏移植手术.
- 在抗血栓避开期内没有观察到主要的血栓并发症.
结论:
- 在选择的儿科患者中,在没有标准抗血栓治疗的情况下,可以在仔细监测下实现持久的HVAD支持.
- 多学科护理和患者教育对于优化VAD患者的治疗结果至关重要.
- 在将特定VAD试验 (如ARIES-HM3) 的结果推断到不同的设备时,建议谨慎.
相关概念视频
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
2.5K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
2.5K
Self-Help Support Groups
363
Self-help support groups are voluntary, community-based organizations that provide a platform for individuals with shared concerns to exchange support, insights, and practical strategies for coping with life challenges. Typically led by group members or paraprofessionals, these groups form a cornerstone of mental health care, especially in reaching populations that are underserved by traditional healthcare systems.
Accessibility and Cost-Effectiveness
One of the primary strengths of self-help...
Accessibility and Cost-Effectiveness
One of the primary strengths of self-help...
363
Anticoagulant Drugs: Low-Molecular-Weight Heparins
2.0K
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
2.0K
Support Reactions
1.5K
A coplanar force system refers to a set of forces that all lie in the same plane and are subject to different reactions between the point of contact and the supports. Understanding how different types of supports affect coplanar forces is crucial for designing safe and reliable structures that can withstand external loads.
The purpose of the supports is to prevent the translational motion of the system by applying an equal and opposite force and to prevent the system's rotation by applying...
The purpose of the supports is to prevent the translational motion of the system by applying an equal and opposite force and to prevent the system's rotation by applying...
1.5K
Support Reactions in Three Dimensions
1.7K
Support reactions in three dimensions help maintain the stability and equilibrium of various structures and systems. These reactions prevent the system from translating and rotating, ensuring the design can withstand external forces and perform its intended function efficiently and safely. Some of the supports providing support reactions in three dimensions are discussed below:
Ball and Socket Joint is one of the supports allowing free rotation about any axis. This freedom of rotation is...
Ball and Socket Joint is one of the supports allowing free rotation about any axis. This freedom of rotation is...
1.7K
Bone as Supporting Connective Tissue
7.0K
Bone tissue forms the internal skeleton of vertebrate animals, providing structure to the body.
Bone Matrix
Bone, or osseous tissue, is a connective tissue that has a large amount of two different types of matrix material. The organic matrix is similar to the matrix material found in other connective tissues, including some amount of collagen and elastic fibers. This gives strength and flexibility to the tissue. The inorganic matrix consists of mineral salts— mostly calcium salts—...
Bone Matrix
Bone, or osseous tissue, is a connective tissue that has a large amount of two different types of matrix material. The organic matrix is similar to the matrix material found in other connective tissues, including some amount of collagen and elastic fibers. This gives strength and flexibility to the tissue. The inorganic matrix consists of mineral salts— mostly calcium salts—...
7.0K


