Single center outcomes after temporary mechanical circulatory assist device prior to Heartmate 3 implantation - a retrospective cohort study.

IF 1.2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Scandinavian Cardiovascular Journal Pub Date : 2024-12-01 Epub Date: 2024-07-04 DOI:10.1080/14017431.2024.2353066
Imran Jamal Iversen, Finn Gustafsson, Kasper Rossing, Peter Hasse Møller-Sørensen, Peter Skov Olsen, Christian Holdflod Møller
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引用次数: 0

Abstract

Objectives. Temporary mechanical circulatory support (TMCS) has become a component in the therapeutic strategy for treatment of cardiogenic shock as a bridge-to-decision. TMCS can facilitate recovery of cardiopulmonary function, end-organ function, and potentially reduce the surgical risk of left ventricular assist device (LVAD) implantation. Despite the improvements of hemodynamics and end-organ function, post-LVAD operative morbidity might be increased in these high-risk patients. The aim of the study was to compare outcomes after Heartmate 3 (HM3) implantation in patients with and without TMCS prior to HM3 implant. Methods. In this retrospective cohort study of all HM3 patients in the period between November 2015 and October 2021, patients with and without prior TMCS were compared. Patients' demographics, baseline clinical characteristics, laboratory tests, intraoperative variables, postoperative outcomes, and adverse events were collected from patient records. Results. The TMCS group showed an improvement in hemodynamics prior to LVAD implantation. Median TMCS duration was 19.5 (14-26) days. However, the TMCS group were more coagulopathic, had more wound infections, neurological complications, and more patients were on dialysis compared with patient without TMCS prior to HM3 implantation. Survival four years after HM3 implantation was 80 and 82% in the TMCS (N = 22) and non-TMCS group (N = 41), respectively. Conclusion. Patients on TMCS had an acceptable short and long-term survival and comparable to patients receiving HM3 without prior TMCS. However, they had a more complicated postoperative course.

在植入 Heartmate 3 之前使用临时机械循环辅助装置后的单中心结果 - 一项回顾性队列研究。
目的。临时机械循环支持(TMCS)已成为治疗心源性休克的治疗策略中的一个组成部分,是决定性的桥梁。临时机械循环支持可促进心肺功能和内脏器官功能的恢复,并有可能降低植入左心室辅助装置(LVAD)的手术风险。尽管血液动力学和内脏器官功能有所改善,但在这些高风险患者中,LVAD 术后发病率可能会增加。本研究的目的是比较在 HM3 植入前使用和未使用 TMCS 的患者植入 Heartmate 3(HM3)后的疗效。研究方法在这项回顾性队列研究中,对 2015 年 11 月至 2021 年 10 月期间的所有 HM3 患者进行了比较。研究人员从患者病历中收集了患者的人口统计学特征、基线临床特征、实验室检查、术中变量、术后结果和不良事件。结果显示TMCS 组患者在植入 LVAD 前血液动力学有所改善。中位 TMCS 持续时间为 19.5(14-26)天。然而,与 HM3 植入前未使用 TMCS 的患者相比,TMCS 组患者更容易发生凝血病变、伤口感染和神经系统并发症,而且更多患者需要接受透析治疗。植入 HM3 四年后,TMCS 组(22 人)和非 TMCS 组(41 人)的存活率分别为 80% 和 82%。结论TMCS患者的短期和长期存活率均可接受,与未接受TMCS的HM3患者不相上下。不过,他们的术后病程更为复杂。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Scandinavian Cardiovascular Journal
Scandinavian Cardiovascular Journal 医学-心血管系统
CiteScore
3.40
自引率
0.00%
发文量
56
审稿时长
6-12 weeks
期刊介绍: The principal aim of Scandinavian Cardiovascular Journal is to promote cardiovascular research that crosses the borders between disciplines. The journal is a forum for the entire field of cardiovascular research, basic and clinical including: • Cardiology - Interventional and non-invasive • Cardiovascular epidemiology • Cardiovascular anaesthesia and intensive care • Cardiovascular surgery • Cardiovascular radiology • Clinical physiology • Transplantation of thoracic organs
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