在接受HeartMate 3左心室辅助装置植入的患者中出现胃肠道出血
Jonathan Eisenberger1, David Koren1, Shmuel Somer1
1Department of Cardiac Surgery, Leviev Cardiothoracic and Vascular Center, Sheba Medical Center, Tel Hashomer, Israel, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
The Israel Medical Association journal : IMAJ
|March 9, 2026
概括
胃肠道出血 (GIB) 影响了HeartMate 3左心室辅助器件 (HM3-LVADs) 的14%的患者,导致发病率,但没有影响生存率. 需要进一步了解GIB病理生理学,以减少其发生.
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:
- 持续流动的左心室辅助器件 (CF-LVADs) 与脉动器件相比,提供了更好的结果.
- 胃肠道出血 (GIB) 仍然是CF-LVAD患者的重要并发症.
- 哈特Mate 3左心室辅助装置 (HM3-LVAD) 具有人工脉冲,与之前的HeartMate 2 (HM2-LVAD) 等模型相比,可能会减少GIB.
研究的目的:
- 为了确定在接受HM3-LVAD支持的患者中GIB的发病率.
- 在这个患者群体中确定GIB的预测因子.
- 评估与HM3-LVAD接收者GIB相关的临床结果和死亡率.
主要方法:
- 在2016年至2024年间对180名接受HM3-LVAD植入的患者进行了回顾性审查.
- 分析患者病历,以确定GIB的流行率,出血来源以及相关的发病率/死亡率.
- 单变量和多变量统计分析以确定GIB的独立预测因素.
主要成果:
- GIB发生在14% (25/180) 的患者中,出血来源包括小肠,直肠,大肠和胃,还有11例没有明确的来源.
- 在64% (16/25) 的受影响患者中观察到复发性GIB.
- 没有任何死亡被归因于GIB,也没有任何人口或历史因素独立预测GIB发展.
结论:
- GIB是HM3-LVADs支持的患者患病的常见原因.
- 虽然GIB很常见,但它不会显著影响患者的存活率.
- 对CF-LVAD患者GIB病理生理学的进一步研究对于制定减轻这种并发症的策略至关重要.
相关概念视频
Aneurysm III: Interprofessional Care
422
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
422
Cardiac Catheterization III: Left Heart Catheterization
951
Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
951
Esophageal Varices-II: Clinical Features and Management
703
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
703
Cardiac Catheterization II: Right Heart Catheterization
1.5K
Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
1.5K


