From the Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany.
ASAIO J. 2010 Sep-Oct;56(5):457-9. doi: 10.1097/MAT.0b013e3181e92f94.
The Paracor HeartNet, a ventricular constraint device for the treatment of heart failure (HF), is implanted through a left lateral thoracotomy. It envelopes the heart like a mesh "bag." This method of application raises the question of whether adhesions with the pericardium allow the safe implantation of a left ventricular assist device (LVAD) if HF worsens. A male patient who had undergone implantation of the Paracor HeartNet 42 months earlier presented with advanced HF for cardiac transplantation. The patient's condition deteriorated, and because no suitable organ for transplantation was available, implantation of an LVAD became necessary. Surgery was performed via a median sternotomy without complications. No severe adhesions were found. This is the first report on "how to do" LVAD implantation after Paracor HeartNet implantation with images and information about cutting the constraint. Because the Paracor HeartNet is "wrapped" around the heart, concerns persist that severe adhesions with the pericardium might occur. In this case, LVAD implantation after therapy with the Paracor HeartNet was without complications, and the expected massive adhesions were absent.
Paracor HeartNet 是一种用于治疗心力衰竭 (HF) 的心室约束装置,通过左侧开胸术植入。它像一个网袋一样包裹着心脏。这种应用方法提出了一个问题,如果 HF 恶化,心包粘连是否允许安全植入左心室辅助装置 (LVAD)。一名男性患者在 42 个月前接受了 Paracor HeartNet 植入,因 HF 恶化而出现晚期 HF ,需要进行心脏移植。患者的病情恶化,由于没有合适的移植器官,因此需要植入 LVAD。手术通过正中胸骨切开术进行,无并发症。未发现严重粘连。这是第一份关于在 Paracor HeartNet 植入后如何进行 LVAD 植入的报告,其中包括图像和关于切割约束的信息。由于 Paracor HeartNet 环绕在心脏周围,因此仍然存在与心包发生严重粘连的担忧。在这种情况下,Paracor HeartNet 治疗后植入 LVAD 没有并发症,并且没有出现预期的大量粘连。