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左心室辅助装置选择中传动系统特征与传动系统感染之间的相关性

Correlation between driveline features and driveline infection in left ventricular assist device selection.

作者信息

Imamura Teruhiko, Murasawa Takahide, Kawasaki Hironori, Kashiwa Koichi, Kinoshita Osamu, Nawata Kan, Ono Minoru

机构信息

Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.

Department of Medical Engineering, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.

出版信息

J Artif Organs. 2017 Mar;20(1):34-41. doi: 10.1007/s10047-016-0923-8. Epub 2016 Jul 22.

Abstract

Although the survival rate for left ventricular assist device (LVAD) therapy has improved, device-related complications are an unpredictable threat to the patient's quality of life. We focused on driveline infection, and aimed to determine whether specific features of drivelines affect the frequency of infection. We enrolled patients who underwent LVAD implantation and were followed-up at our institute between 2007 and 2015. We counted the occurrences of driveline infection requiring any antibiotic therapy over a 2-year study period. Furthermore, we experimentally measured and compared the outer diameters and stiffness of three devices. Of all, 72 patients received an LVAD during the enrollment period. LVADs were HeartMate II (n = 32), EVAHEART (n = 22), and DuraHeart (n = 18). The outer diameters and stiffness were measured in five of each device. HeartMate II group had the highest driveline infection-free rate among all three devices during the study period (p = 0.042). The driveline of the HeartMate II LVAD had a significantly smaller outer diameter and lower stiffness than that of the other two devices (p < 0.05 for both). In conclusion, device-specific driveline features may affect the development of driveline infection during LVAD therapy.

摘要

尽管左心室辅助装置(LVAD)治疗的生存率有所提高,但与装置相关的并发症对患者的生活质量构成了不可预测的威胁。我们重点关注了驱动线感染,并旨在确定驱动线的特定特征是否会影响感染频率。我们纳入了2007年至2015年间在我院接受LVAD植入并接受随访的患者。我们统计了在为期2年的研究期间需要任何抗生素治疗的驱动线感染的发生情况。此外,我们通过实验测量并比较了三种装置的外径和硬度。在纳入期间,共有72例患者接受了LVAD治疗。LVAD分别为HeartMate II(n = 32)、EVAHEART(n = 22)和DuraHeart(n = 18)。每种装置各选取5个测量其外径和硬度。在研究期间,HeartMate II组在所有三种装置中的无驱动线感染率最高(p = 0.042)。HeartMate II LVAD的驱动线外径明显小于其他两种装置,硬度也低于其他两种装置(两者p均<0.05)。总之,特定装置的驱动线特征可能会影响LVAD治疗期间驱动线感染的发生。

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