• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Artificial Organs >Use of Left Ventricular Assist Device (HeartMate II): A Singapore Experience
【24h】

Use of Left Ventricular Assist Device (HeartMate II): A Singapore Experience

机译：左心室辅助装置的使用（HeartMate II）：新加坡的体验

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Recent advances in medical and device therapies in heart failure have improved the survival of patients with heart failure. However, due to the limited availability of suitable heart donors, left ventricular assist devices (LVADs) have become an important tool as a bridge-to-heart transplantation for patients with refractory heart failure in Singapore. We report our experience with the HeartMate II (HMII) LVAD (Thoratec Corporation, Pleasanton, CA, USA) as a bridge-to-heart transplant in our center from 2009 to 2012. This was a retrospective review of 23 consecutive patients who underwent HMII LVAD implantation in our center between May 2009 and December 2012. All patients were classified as Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) levels 1 to 3 and underwent LVAD implantation as a bridge-to-heart transplant. There were 17 male and 6 female patients. The mean age was 43.6 years old (range 14 to 64). The etiologies of heart failure included ischemic heart disease [8], idiopathic dilated cardiomyopathy [11], viral myocarditis [2], and chemotherapy-induced cardiomyopathy [2]. Nine patients were INTERMACS level 1, 12 patients level 2, and two patients level 3. All patients successfully underwent HMII LVAD implantation. There was no mortality within the first 30 postoperative days. Postoperative complications included stroke with full neurological recovery (21.7%), mediastinal infection (21.7%), cardiac tamponade or mediastinal collection requiring reopening of the chest (39.1%), cardiac arrhythmia (13.0%), and pump thrombosis with pump replacement (4.3%). All patients were discharged from hospital after LVAD implantation. Three patients experienced driveline infections during outpatient follow-up. There were 19 readmissions due to the following conditions: sub-therapeutic anticoagulation (13.0%), gastrointestinal bleeding (13.0%), suspected pump thrombosis (13.0%), transient ischemic attack (8.7%), arrhythmia (8.7%), congestive cardiac failure due to severe aortic regurgitation (8.7%), right ventricular failure (4.3%), rhabdomyolysis (4.3%), and hematuria (4.3%). Post-LVAD implantation, 20 patients were functionally New York Heart Association (NYHA) class I, while 3 reported NYHA III symptoms. Three patients were successfully bridged to heart transplantation. One patient was successfully explanted 11 months after LVAD implantation. There were two mortalities during the follow-up period. The average duration of LVAD support was 522 days (range 47 to 1316 days). The HeartMate II LVAD has proven to be effective in our Asian population. Driveline infection rate remains low even in the tropical hot, humid climate in Singapore. With more patients ending up on extended periods of LVAD support, increased emphasis in the detection and management of long-term complications of ventricular assist devices will be needed.
机译：心力衰竭的医学和设备疗法的最新进展提高了心力衰竭患者的生存率。然而，由于合适的心脏供体的供应有限，左心室辅助设备（LVAD）已成为新加坡难治性心力衰竭患者作为心脏桥式移植的重要工具。我们报告了我们从2009年至2012年在我们中心进行的Heart-Mate II（HMII）LVAD（Thoratec Corporation，Pleasanton，CA，美国）作为心脏桥移植的经验。这是对23例连续接受HMII的患者的回顾性回顾。 LVAD植入在我们中心于2009年5月至2012年12月之间。所有患者均被分类为机械辅助循环支持（INTERMACS）级别为1至3的机构间注册，并接受了LVAD植入作为心脏桥式移植。男17例，女6例。平均年龄为43.6岁（范围为14到64）。心力衰竭的病因包括缺血性心脏病[8]，特发性扩张型心肌病[11]，病毒性心肌炎[2]和化疗引起的心肌病[2]。 9名患者为INTERMACS 1级，12名患者2级和2名患者3级。所有患者均成功接受了HMII LVAD植入。术后头30天内无死亡。术后并发症包括中风，神经功能完全恢复（21.7％），纵隔感染（21.7％），心脏压塞或纵隔收集需要重新张开胸腔（39.1％），心律不齐（13.0％），以及泵更换引起的泵血栓形成（4.3） ％）。 LVAD植入后所有患者均出院。三名患者在门诊随访期间经历了传动系统感染。因以下情况而入院19例：亚治疗性抗凝（13.0％），胃肠道出血（13.0％），可疑泵血栓形成（13.0％），短暂性脑缺血发作（8.7％），心律不齐（8.7％），充血性心脏严重的主动脉瓣关闭不全（8.7％），右心室衰竭（4.3％），横纹肌溶解（4.3％）和血尿（4.3％）引起的衰竭。 LVAD植入后，有20例患者在功能上属于纽约心脏协会（NYHA）I级，而3例报告了NYHA III症状。三名患者成功桥接心脏移植。 LVAD植入后11个月，一名患者成功移出。在随访期间有两次死亡。 LVAD支持的平均持续时间为522天（范围为47到1316天）。已证明HeartMate II LVAD在我们的亚洲人群中有效。即使在新加坡的热带高温潮湿气候中，传动系统的感染率仍然很低。随着更多患者最终获得延长的LVAD支持，将需要更加重视对心室辅助设备长期并发症的检测和管理。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号