Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.
Eur J Cardiothorac Surg. 2013 Jun;43(6):1233-6. doi: 10.1093/ejcts/ezs568. Epub 2012 Dec 9.
From 2004 to 2009, rotary blood pumps were implanted for heart failure as a bridge to transplant or destination therapy in 101 male and 14 female patients at our institution. We report on our experiences of these patients with a follow-up of 132 patient years.
Seventy-four HeartMate II axial flow pumps and 41 HeartWare centrifugal pumps were implanted in patients with non-ischaemic (n = 70) or ischaemic cardiomyopathy (n = 45). The mean age of the patients was 50 ± 13 years. All patients were on inotropic support prior to implantation. Extracorporeal membrane oxygenation was used as a bridging procedure in 21 cases.
The perioperative mortality was 14%. Hospital discharge occurred on average after 46 ± 33 days. Twenty-two patients of this cohort received a heart transplant 492 ± 342 days after implantation of the device. Two patients died after heart transplantation. A 1-year survival of 73% and a 2-year survival of 69% were recorded, despite a low incidence of transplant procedures. The longest support time was 1686 days.
Modern left ventricular assist device technology can be used successfully for heart failure. The scarcity of donor hearts leads to prolonged periods on the device, and chronic ventricular assist device therapy has become a reality, although bridge to transplant was intended; therefore, sufficient support services for outpatient care of these patients are required.
从 2004 年到 2009 年,我们机构为 101 名男性和 14 名女性心力衰竭患者植入了旋转血泵,作为移植或目的地治疗的桥梁。我们报告了这些患者的经验,随访时间为 132 患者年。
在我们的机构中,74 名 HeartMate II 轴流泵和 41 名 HeartWare 离心泵被植入非缺血性(n=70)或缺血性心肌病(n=45)患者体内。患者的平均年龄为 50±13 岁。所有患者在植入前都接受了正性肌力支持。在 21 例病例中,体外膜氧合被用作桥接程序。
围手术期死亡率为 14%。平均在术后 46±33 天出院。该队列中有 22 名患者在装置植入后 492±342 天接受了心脏移植。两名患者在心脏移植后死亡。记录到 1 年生存率为 73%,2 年生存率为 69%,尽管移植手术的发生率较低。最长支持时间为 1686 天。
现代左心室辅助装置技术可成功用于心力衰竭。供心稀缺导致在装置上的时间延长,慢性心室辅助装置治疗已成为现实,尽管初衷是桥接移植;因此,需要为这些患者的门诊护理提供充足的支持服务。