Extrinsic outflow graft obstruction of the HeartMate 3 LVAD: A state-of-the-art review

IF 6.4 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Heart and Lung Transplantation Pub Date : 2024-07-15 DOI:10.1016/j.healun.2024.07.005

Daniel J. Goldstein MD , Manreet Kanwar MD , Jennifer Cowger MD , Snehal Patel MD , Dan M. Meyer MD , Ezequiel Molina MD , Christopher Salerno MD , Ashley Elmer BS , Sarah Schettle PA-C, MBA , Jeffrey Teuteberg MD , Francis Pagani MD, PhD , Josef Stehlik MD

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引用次数: 0

Abstract

While notable improvements in survival, the incidence of hemocompatibility-related adverse events, hospitalizations, and cost have been demonstrated with the only commercially available durable left ventricular assist device, a category of pump malfunctions characterized by outflow graft obstruction has been noted with broader use and clinical follow-up of recipients of this technology. Of particular concern is the accumulation of acellular biodebris between the outflow graft and bend relief covering the outflow graft at its origin with the pump (which we term extrinsic outflow graft obstruction at the bend relief). This process tends to be insidious, occurs late in the postoperative course, can be challenging to diagnose, and can result in significant morbidity and mortality. Herein, we provide a review of this complication and outline diagnostic, treatment, and preventive strategies.

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HeartMate 3 LVAD 的外源性外流移植物阻塞：最新研究综述。

虽然唯一的商用耐用左心室辅助装置在存活率、血液相容性相关不良事件发生率、住院率和成本方面都有显著改善，但随着该技术的广泛使用和对受术者的临床随访，我们发现了一类以流出移植物阻塞为特征的泵故障。尤其令人担忧的是，在流出移植物与泵连接处覆盖流出移植物的弯管之间积累了无细胞生物碎屑（我们称之为弯管处的外源性流出移植物阻塞，或 EOGO-BR）。这一过程往往很隐蔽，发生在术后晚期，诊断起来很困难，并可能导致严重的发病率和死亡率。在此，我们将对这一并发症进行回顾，并概述诊断、治疗和预防策略。

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

Journal of Heart and Lung Transplantation 医学-呼吸系统

CiteScore

10.10

自引率

6.70%

发文量

1667

审稿时长

69 days

期刊介绍： The Journal of Heart and Lung Transplantation, the official publication of the International Society for Heart and Lung Transplantation, brings readers essential scholarly and timely information in the field of cardio-pulmonary transplantation, mechanical and biological support of the failing heart, advanced lung disease (including pulmonary vascular disease) and cell replacement therapy. Importantly, the journal also serves as a medium of communication of pre-clinical sciences in all these rapidly expanding areas.