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用游离皮瓣覆盖植入式左心室辅助装置(DuraHeart)。

Covering implantable left ventricular assist device (DuraHeart) with free flap.

作者信息

Matsuda Ken, Nishibayashi Akimitsu, Toda Koichi, Fujiwara Takashi, Fukai Megumi, Yoshioka Daisuke, Sawa Yoshiki, Hosokawa Ko

机构信息

Division of Plastic and Reconstructive Surgery, Niigata University Graduate School of Medicine, 1-757, Asahimachi-Dori, Chuo-ku, Niigata, 951-8510, Japan,

出版信息

J Artif Organs. 2015 Jun;18(2):114-9. doi: 10.1007/s10047-014-0812-y. Epub 2014 Dec 23.

Abstract

Severe donor shortage in Japan makes the waiting period for heart transplantation extremely long and the left ventricular assist devices (LVADs) are often used for bridge-to-transplant. We present three cases of infected and exposed DuraHeart LVAD system treated with free flaps. Four free flaps (two latissimus flaps and two anterolateral thigh flaps) were transferred using the right internal thoracic vessels or left deep inferior epigastric vessels as recipients. The potential significance of the continuous low pressure blood flow generated by the LVAD system on microvascular patency has not been previously reported. All flaps survived and worked efficiently to control the infection and cover the devices. Heart transplantation was conducted in the two of three patients. Free flap transfer is an efficient treatment for the patients with infected and exposed implantable LVAD.

摘要

日本严重的供体短缺使得心脏移植的等待期极长,左心室辅助装置(LVAD)常被用作移植过渡。我们报告3例采用游离皮瓣治疗的感染并外露的DuraHeart LVAD系统病例。使用右胸廓内血管或左腹壁下深血管作为受区血管,转移了4个游离皮瓣(2个背阔肌皮瓣和2个股前外侧皮瓣)。LVAD系统产生的持续低压血流对微血管通畅性的潜在意义此前未见报道。所有皮瓣均存活,并有效控制了感染,覆盖了装置。3例患者中有2例接受了心脏移植。游离皮瓣转移是治疗感染并外露可植入LVAD患者的有效方法。

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