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在栓塞性中风后采用两阶段HeartWare左心室辅助装置取出术成功过渡到康复阶段。

Successful bridge to recovery using two-stage HeartWare LVAD explantation approach after embolic stroke.

作者信息

Sabashnikov Anton, Högerle Benjamin A, Mohite Prashant N, Popov Aron-Frederik, Sáez Diana García, Fatullayev Javid, Amrani Mohamed, Wahlers Thorsten, Simon André R, Bahrami Toufan

机构信息

Department of Cardiothoracic Transplantation & Mechanical Support, Royal Brompton and Harefield NHS Trust, Harefield Hospital, Hill End Road, Harefield, Middlesex, United Kingdom UB9 6JH.

出版信息

J Cardiothorac Surg. 2013 Dec 30;8:233. doi: 10.1186/1749-8090-8-233.

DOI:10.1186/1749-8090-8-233
PMID:24377791
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3892123/
Abstract

A two-stage explantation of a left ventricular assist device (LVAD) was performed on 47 year old afro-american gentlemen with non-ischemic dilated cardiomyopathy (DCM) who was successfully bridged to recovery. After he suffered a stroke caused by a VAD thrombosis with embolisation, the VAD outflow graft was first ligated using minimally-invasive approach. Two months later, the device was explanted and a manufactured titanium plug was placed into the sewing ring. This stepwise procedure might be beneficial in cases of high thromboembolic risk and in patients who suffered a thromboembolic event previously.

摘要

对一名47岁患有非缺血性扩张型心肌病(DCM)的非裔美国男性患者进行了两阶段的左心室辅助装置(LVAD)取出手术,该患者成功过渡到康复阶段。在他因VAD血栓形成伴栓塞导致中风后,首先采用微创方法结扎了VAD流出移植物。两个月后,取出装置,并在缝合环处放置了一个定制的钛塞。对于血栓栓塞风险高的病例以及先前发生过血栓栓塞事件的患者,这种分步进行的手术可能是有益的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b864/3892123/e9ed9697cc1f/1749-8090-8-233-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b864/3892123/42a52012bfb1/1749-8090-8-233-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b864/3892123/e9ed9697cc1f/1749-8090-8-233-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b864/3892123/42a52012bfb1/1749-8090-8-233-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b864/3892123/e9ed9697cc1f/1749-8090-8-233-2.jpg

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本文引用的文献

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HeartWare miniaturized intrapericardial ventricular assist device: advantages and adverse events in comparison to contemporary devices.心伟(HeartWare)微型心包内心室辅助装置:与当代装置相比的优势和不良事件。
Expert Rev Med Devices. 2013 Jul;10(4):441-52. doi: 10.1586/17434440.2013.811851.
2
Minimally invasive access for off-pump HeartWare left ventricular assist device explantation.非体外循环下HeartWare左心室辅助装置取出术的微创入路
Interact Cardiovasc Thorac Surg. 2013 Sep;17(3):581-2. doi: 10.1093/icvts/ivt239. Epub 2013 Jun 19.
3
Expeditious and less traumatic explantation of a heartware LVAD after myocardial recovery.
心肌恢复后快速且创伤较小的心助手 LVAD 取出。
ASAIO J. 2012 Sep-Oct;58(5):542-4. doi: 10.1097/MAT.0b013e3182640dce.
4
Clinical experience with HeartWare left ventricular assist device in patients with end-stage heart failure.HeartWare 左心室辅助装置在终末期心力衰竭患者中的临床应用经验。
Ann Thorac Surg. 2012 Mar;93(3):810-5. doi: 10.1016/j.athoracsur.2011.11.076. Epub 2012 Jan 29.
5
HeartWare left ventricular assist device implantation through bilateral anterior thoracotomy.经双侧前胸切开植入 HeartWare 左心室辅助装置。
Ann Thorac Surg. 2012 Feb;93(2):674-6. doi: 10.1016/j.athoracsur.2011.09.055.
6
Reversal of severe heart failure with a continuous-flow left ventricular assist device and pharmacological therapy: a prospective study.使用持续血流左心室辅助装置和药物治疗逆转严重心力衰竭:一项前瞻性研究。
Circulation. 2011 Feb 1;123(4):381-90. doi: 10.1161/CIRCULATIONAHA.109.933960. Epub 2011 Jan 17.
7
Left ventricular assist device and drug therapy for the reversal of heart failure.左心室辅助装置与药物治疗用于心力衰竭的逆转
N Engl J Med. 2006 Nov 2;355(18):1873-84. doi: 10.1056/NEJMoa053063.