Successful management of HeartMate 3 in a patient with arrhythmogenic right ventricular cardiomyopathy.

IF 1.1 4区 医学 Q4 ENGINEERING, BIOMEDICAL
Makiko Nakamura, Teruhiko Imamura, Yuki Hida, Toshihide Izumida, Masaki Nakagaito, Saori Nagura, Toshio Doi, Kazuaki Fukahara, Koichiro Kinugawa
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Abstract

The management of right heart failure during durable left ventricular assist device (LVAD) support remains an unsolved issue so far. We had a 44-year-old male patient who was diagnosed with arrhythmogenic right ventricular cardiomyopathy and received HeartMate 3 LVAD (Abbott, USA) implantation as a bridge-to-transplant indication. The pump speed was adjusted as low as 4500 rpm to avoid the left ventricular narrowing and interventricular septal leftward shift. Riociguat was administered to decrease the afterload of the right ventricle and increase the preload of the left ventricle, in addition to the combination of neurohormonal blockers. Frequent low-flow alarm events eventually disappeared after amlodipine administration, and he was successfully returned to work. We here present a unique management in a patient with right heart failure due to arrhythmogenic right ventricular cardiomyopathy during HeartMate 3 LVAD support.

Abstract Image

成功治疗一名心律失常性右室心肌病患者的 HeartMate 3。
耐用左心室辅助装置(LVAD)支持期间的右心衰竭管理至今仍是一个悬而未决的问题。我们有一名 44 岁的男性患者,他被诊断为心律失常性右室心肌病,并接受了 HeartMate 3 LVAD(雅培,美国)植入手术,作为移植前的桥接适应症。为避免左心室狭窄和室间隔左移,泵速被调低至每分钟 4500 转。除了联合使用神经激素阻滞剂外,还使用了利奥吉曲特(Riociguat)来降低右心室的后负荷和增加左心室的前负荷。服用氨氯地平后,频繁的低流量报警事件最终消失,他也成功重返工作岗位。我们在此介绍了在 HeartMate 3 LVAD 支持期间对心律失常性右心室心肌病导致的右心衰竭患者的独特治疗方法。
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来源期刊
Journal of Artificial Organs
Journal of Artificial Organs 医学-工程:生物医学
CiteScore
2.80
自引率
15.40%
发文量
68
审稿时长
6-12 weeks
期刊介绍: The aim of the Journal of Artificial Organs is to introduce to colleagues worldwide a broad spectrum of important new achievements in the field of artificial organs, ranging from fundamental research to clinical applications. The scope of the Journal of Artificial Organs encompasses but is not restricted to blood purification, cardiovascular intervention, biomaterials, and artificial metabolic organs. Additionally, the journal will cover technical and industrial innovations. Membership in the Japanese Society for Artificial Organs is not a prerequisite for submission.
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