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使用耐用型右心室辅助装置治疗因毛细血管前和毛细血管后肺动脉高压合并引起的单纯性右心室衰竭。

The use of a durable right ventricular assist device for isolated right ventricular failure due to combined pre- and postcapillary pulmonary hypertension.

作者信息

Vullaganti Sirish, Tibrewala Anjan, Rich Jonathan D, Pham Duc T, Rich Stuart

机构信息

1 Division of Cardiology, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

2 Department of Cardiac Surgery, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

出版信息

Pulm Circ. 2019 Apr-Jun;9(2):2045894019831222. doi: 10.1177/2045894019831222.

Abstract

Patients with isolated right ventricular (RV) failure have poor outcomes and minimal treatment options. We report a case where a durable RV assist device (RVAD) was implanted for end-stage RV failure from combined pre- and postcapillary pulmonary hypertension (PH) due in part to chronic thromboembolic PH using a temporary percutaneous RVAD as a bridging strategy. While the patient ultimately died from non-cardiovascular causes, there was significant improvement in markers of cardiogenic shock and hemodynamic RV function parameters without adverse effects from increased pulmonary artery pressures. More research is needed to identify an appropriate long-term mechanical support strategy for this patient population.

摘要

孤立性右心室(RV)衰竭患者预后较差且治疗选择有限。我们报告了一例病例,该患者因合并毛细血管前和毛细血管后肺动脉高压(PH)导致终末期RV衰竭,部分原因是慢性血栓栓塞性PH,使用临时经皮RV辅助装置(RVAD)作为桥接策略植入了耐用的RVAD。虽然患者最终死于非心血管原因,但心源性休克标志物和血流动力学RV功能参数有显著改善,且肺动脉压升高无不良影响。需要更多研究来确定针对该患者群体的合适长期机械支持策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f88/6540493/b519e5e60f0d/10.1177_2045894019831222-fig1.jpg

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