左心室辅助装置在左心室心肌致密化不全患者中的应用价值
Usefulness of a left ventricular assist device in patients with left ventricular noncompaction.
作者信息
Hashemi Helen, Raza Fayez S, Harmon David M, Alias Tony, Felius Joost, Sherwood Melody J
机构信息
Department of Internal Medicine, Baylor University Medical Center, Dallas, Texas.
Baylor Heart and Vascular Institute, Baylor Scott and White Research Institute, Dallas, Texas.
出版信息
Proc (Bayl Univ Med Cent). 2018 Feb 1;31(1):61-63. doi: 10.1080/08998280.2017.1401342. eCollection 2018 Jan.
Left ventricular noncompaction (LVNC) is a multifactorial structural abnormality of the myocardial wall characterized by prominent trabeculae and deep trabecular recesses. LVNC may present as a congenital or acquired defect characterized by 2 distinct tissue layers: a spongy, noncompacted inner myocardium and a thin, compacted outer myocardium. Patients with LVNC are prone to thromboembolic events, either due to deep trabeculations in the noncompacted myocardium or due to arrhythmias accompanying the defect. There are sparse data concerning treatment options for patients with LVNC who fail medical management. We present 2 such patients with LVNC who, following failed medical management, received a left ventricular assist device (LVAD): one for long-term management and one as a bridge to transplant. Both were managed successfully without thromboembolic events to date. The success of these cases suggests that LVAD placement is a viable therapy in patients with LVNC as a bridge to transplant or as long-term management.
左心室心肌致密化不全（LVNC）是一种心肌壁的多因素结构异常，其特征为显著的肌小梁和深陷的小梁隐窝。LVNC可表现为先天性或后天性缺陷，其特点是有两个不同的组织层：海绵状、未致密化的内心肌层和薄的、致密化的外心肌层。LVNC患者容易发生血栓栓塞事件，这要么是由于未致密化心肌中的深陷小梁，要么是由于该缺陷伴随的心律失常。对于药物治疗无效的LVNC患者，关于治疗选择的数据很少。我们介绍2例这样的LVNC患者，他们在药物治疗失败后接受了左心室辅助装置（LVAD）：1例用于长期管理，1例作为移植桥梁。迄今为止，两人均成功管理，未发生血栓栓塞事件。这些病例的成功表明，LVAD植入对于LVNC患者作为移植桥梁或长期管理是一种可行的治疗方法。
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