Bridge to heart transplantation in patients with cardiogenic shock: a 20-year experience with two different surgical strategies

Sandro Sponga; A. Dave Nagpal; Igor Vendramin; Veronica Ferrara; Andrea Lechiancole; Massimo Maiani; Chiara Nalli; Concetta Di Nora; Giorgio Guzzi; Nunzio D. De Manna; Uberto Bortolotti; Ugolino Livi

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Bridge to heart transplantation in patients with cardiogenic shock: a 20-year experience with two different surgical strategies

机译：伴有心绞痛休克患者心脏移植的桥梁：20年的两年内具有两种不同的外科策略

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Aims We aimed to describe how treatment of patients in cardiogenic shock bridged to heart transplantation with mechanical circulatory support, using either biventricular assist devices (BVADs) or extracorporeal life support (ECLS), has evolved in the last 20 years in our centre. Methods Since 1998, 72 patients with refractory heart failure and indication for heart transplantation have received mechanical circulatory support: 40 had an ECLS system and 32 a BVAD. Results Early mortality was similar (17.5 vs. 9.4%, P ?=?0.25) regardless of the type of support. After a median support time of 8 (1–27) vs. 34 (0–385) days ( P ?

机译：目的我们的目的是描述在过去20年中，我们中心如何通过双心室辅助装置（BVADs）或体外生命支持（ECLS）将心源性休克患者的治疗过渡到机械循环支持的心脏移植。方法自1998年以来，72例有心脏移植指征的难治性心力衰竭患者接受了机械循环支持：40例接受ECLS系统，32例接受BVAD。结果无论支持类型如何，早期死亡率相似（分别为17.5%和9.4%，P=0.25）。在中位支持时间分别为8（1-27）天和34（0-385）天（P<0.01）后，两组分别有70%和65.6%（P=0.69）的患者接受了移植。移植前，BVAD患者更稳定，对机械通气（9对57%，P<0.01）和透析（0对38%，P<0.01）的需求更低。移植后30天的死亡率相似（分别为18%和14%，P=0.53）。接受体外支持的患者肾衰竭（P？=？0.02）和呼吸衰竭（P？=？0.03）、感染（P？=？0.02）、心房颤动（P？=？0.03）和ICU住院时间较长（P？=？0.01）的发生率较高。晚期存活率相似，而BVAD患者的5年无冠状动脉血管病变率较高（P？=？0.03）。结论尽管ECLS比BVADs提供更快、更简单的协助，但在过去20年中，心源性休克患者的早期和中期预后没有差异。然而，BVADs提供了更长的支持时间，更好的多器官恢复，允许更充分的移植物选择，从而降低了移植后并发症的发生率。

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来源
《Journal of cardiovascular medicine》 |2021年第5期|共8页
作者
Sandro Sponga; A. Dave Nagpal; Igor Vendramin; Veronica Ferrara; Andrea Lechiancole; Massimo Maiani; Chiara Nalli; Concetta Di Nora; Giorgio Guzzi; Nunzio D. De Manna; Uberto Bortolotti; Ugolino Livi;
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作者单位

Cardiothoracic Department University Hospital of Udine;

Division of Cardiac Surgery and Critical Care Medicine London Health Sciences Centre;

Cardiothoracic Department University Hospital of Udine;

Department of Medicine (DAME) University of Udine;

Cardiothoracic Department University Hospital of Udine;

Cardiothoracic Department University Hospital of Udine;

Cardiothoracic Department University Hospital of Udine;

Cardiothoracic Department University Hospital of Udine;

Cardiothoracic Department University Hospital of Udine;

Cardiothoracic Department University Hospital of Udine;

Cardiothoracic Department University Hospital of Udine;

Cardiothoracic Department University Hospital of Udine;

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正文语种 eng
中图分类心脏、血管（循环系）疾病;
关键词
bridge to transplant; biventricular assist device; cardiogenic shock; extracorporeal life support; heart transplantation;

机译：桥接到移植;五年级辅助装置;心形成休克;体外寿命支持;心脏移植;

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2. One-year clinical outcomes in invasive treatment strategies for acute ST-elevation myocardial infarction complicated by cardiogenic shock in eld-erly patients [J] . Yeon Pyo Yoo, Ki-Woon Kang, Hyeon Soo Yoon, 老年心脏病学杂志（英文版） . 2013,第003期
3. Exploring the Experiences of Chinese Patients Waiting for Heart Transplantation [J] . Hongxia Song, Jianhong Qiao, Yunfeng Li, 心血管病（英文） . 2021,第003期
4. SHORT-TERMVENTRICULAR ASSIST DEVICE AS A BRIDGE TO LONG-TERM ASSIST DEVICE - HEART TRANSPLANTATION IN CARDIOGENIC SHOCK: IS IT A JUSTIFIED STRATEGY? [J] . Koch A., Mohite P., Zeriouh M., Transplant international : . 2015,第Suppla2期

机译：短暂的脑室辅助设备是长期辅助设备的桥梁-心脏电击的心脏移植：这是一种合理的策略吗？
5. Temporary Biventricular Assist Device to Bridge a Patient With Cardiogenic Shock Due to AL Amyloidosis to Heart Transplantation [J] . Al‐Lawati Kumayl, Lim Hoong Sern Artificial Organs . 2017,第12期

机译：临时五个辅助装置，以施用患者的患者，由于Al淀粉样症状到心脏移植而导致的患者
6. Similar transplantation outcomes in patients bridged with cardiac assist devices for acute cardiogenic shock versus chronic heart failure [J] . Stavros G. Drakos, Abdallah G. Kfoury, James W. Long, European Journal of Heart Failure . 2007,第8期

机译：与急性心源性休克和慢性心力衰竭心脏辅助装置桥接的患者的移植结果相似
7. Comprehensive surgical intestinal rescue and transplant program in adult patients: bologna experience [C] . Zanfi C, Lauro A., Cescon M., International Small Bowel Transplant Symposium . 2009

机译：成人患者综合手术肠救援和移植程序：博洛尼亚经验
8. Improving Pre-Transplant Experiences for ICU Patients on the Heart Transplant Registry [D] . Heid, Kacie. 2020

机译：改善ICU患者在心脏移植登记处的移植前经验
9. Percutaneous Coronary Intervention (PCI) Strategies under Hemodynamic Support for Cardiogenic Shock: A Single-Center Experience with Two Patients [O] . Talha Ahmed, Diljon Chahal, Ronson J. Madathil, 2020

机译：血流动力学支持下的经皮冠状动脉干预（PCI）策略对心形成休克：两个患者的单中心经验
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11. Analysis of the Extent of Completion of Skin Assessments and Documentation ofRisk for Skin Breakdown in the Trauma Patient Who Experiences Hypovolemic Shock Requiring Massive Transfusion Resuscitation and Surgical Intervention [R] . Kolesar, M. 1991

机译：对经历低血容量性休克的创伤患者进行大量输血复苏和手术干预的皮肤评估完成皮肤评估和皮肤损伤记录的分析

Bridge to heart transplantation in patients with cardiogenic shock: a 20-year experience with two different surgical strategies

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