[植入式左心室辅助装置在我院治疗晚期心衰的疗效及长期应用前景]。

Q4 Medicine
Masahiko Ezure
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引用次数: 0

摘要

自2011年以来,我院共随访植入式心室辅助装置(VAD)患者13例,其中11例作为移植的桥梁治疗(BTT), 2例作为目的治疗(DT)。除2例桥对桥(BTB)病例外,所有患者均植入左VAD (LVAD), INTERMACS配置等级为2至4级。4名患者选择了EVAHEART LVAD, 4名患者选择了Jarvic2000, 5名患者选择了HeartMate3。围手术期无重大并发症。每周由VAD团队成员提供门诊服务。在13名患者中,6人接受了移植,2人在支持期间死亡,5人仍在进行中。平均支持38个月(3例超过60个月)。8例患者需要再次住院一次以上。前三名患者分别在4个月、10个月和25个月出现脑出血。1例患者右心衰严重,反复住院22次。没有传动系统感染,没有中度以上的主动脉反流。几例患者持续进行心脏康复,体力和通气能力得到改善。由于设备的进步和门诊护理的适当管理,引起植入式VAD的并发症正在减少。目前的植入式LVAD不仅可以作为BTT,还可以作为DT安全用于晚期心力衰竭患者。我们也可以期待未来植入式VAD系统技术的改进。然而,对于DT患者的长期随访,将考虑年龄的变化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Outcomes of Implantable Left Ventricular Assist Device for Treating Advanced Heart Faire in Our Institute and Outlook for Long-term Use].

From 2011, 13 patients with implantable ventricular assist device (VAD) have followed in our institute, 11 as a bridge to transplant (BTT), and two as destination therapy (DT). All patients were implanted left VAD (LVAD) in INTERMACS profile level 2 to 4, except two as a bridge to bridge (BTB) cases. The EVAHEART LVAD was selected in four, Jarvic2000 was in four, and HeartMate3 was in five patients. There were no major complications in perioperative period. Outpatient cares were provided by VAD team members every week. Of the 13 patients, six underwent transplant, two died during support and five are ongoing. Support averaged 38 months( three cases over 60 months). Eight patients required rehospitalization for more than one time. First three patients had cerebral hemorrhages in four, 10 and 25 months. One patient suffered severe right heart faire, and was repeatedly hospitalized( 22 times). There was no driveline infection, and no aortic regurgitation over moderate level. Several patients have continued cardiac rehabilitation, and improved physical strength and ventilatory power. Complications caused implantable VAD have been decreasing due to progressions of the device and appropriate managements for outpatient care. The current implantable LVAD can be used safely in advanced heart failure patients not only as BTT but also as DT. We can look forward to improve the technology of implantable VAD system in the future too. However, aging changes will be considered for long term follow-up of the DT patients.

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