Krishan Kewal, Pinney Sean, Anyanwu Anelechi C
Department of Cardiothoracic Surgery, Mount Sinai Medical Center, New York, NY 10029, USA.
Interact Cardiovasc Thorac Surg. 2010 Feb;10(2):325-7. doi: 10.1510/icvts.2009.221036. Epub 2009 Nov 30.
In patients with left-sided mechanical aortic prostheses, it is recommended that the mechanical valve be replaced with a bioprosthesis, or excluded, at implantation of left ventricular assist device (LVAD). As changes in flow across the valve leads to potential thromboembolic complications, mechanical valves within the native heart are a relative contraindication to LVAD therapy. We here describe a patient who had long-standing valvular cardiomyopathy with mitral Starr-Edwards mechanical valve (Edwards Lifesciences, CA, USA) and aortic bileaflet tilting disc (St Jude Medical, St Paul, MN, USA) where LVAD was placed without explantation of the mechanical heart valves. The patient was bridged successfully to transplantation without thromboembolic events.
对于植入了左侧机械主动脉瓣膜的患者，建议在植入左心室辅助装置（LVAD）时，将机械瓣膜更换为生物瓣膜或不植入机械瓣膜。由于流经瓣膜的血流变化会导致潜在的血栓栓塞并发症，因此，心脏内的机械瓣膜是LVAD治疗的相对禁忌证。我们在此描述一名患有长期瓣膜性心肌病的患者，其二尖瓣为Starr-Edwards机械瓣膜（美国加利福尼亚州爱德华兹生命科学公司），主动脉瓣为双叶倾斜盘式瓣膜（美国明尼苏达州圣保罗市圣犹达医疗公司），该患者在未切除机械心脏瓣膜的情况下植入了LVAD。患者成功过渡到移植阶段，未发生血栓栓塞事件。
