Carrozzini Massimiliano, Bejko Jonida, Gregori Dario, Gerosa Gino, Bottio Tomaso
Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy.
J Artif Organs. 2019 Sep;22(3):188-193. doi: 10.1007/s10047-019-01104-8. Epub 2019 Apr 22.
The post-auricular (PA) driveline positioning for percutaneous power delivery is a specific feature of the Jarvik 2000 FlowMaker LVAD. We applied several technical refinements to optimise the PA implant. Here, we present and discuss these modifications. We retrospectively reviewed all patients implanted with Jarvik 2000 at our Institution. Different PA implant techniques were described. A machine learning analysis was performed to evaluate the determinants of driveline infection. From December 2008 to December 2017, 62 patients were implanted with Jarvik 2000, at our Institution. The PA connection was managed through the "question mark-shaped" incision in 24 patients (39%) and with the "C-shaped" in 18 (29%), whereas 10 (16%) cases received the "vertical incision" and 10 (16%) the "orthogonal incision". The implant technique resulted highly predictive of driveline infection. The rate of driveline infections was numerically lower among cases managed with the last two techniques. After evolving through different implant techniques, we propose and suggest the "orthogonal incision" to maximise the advantages of the Jarvik 2000 post-auricular driveline.
经皮能量传输的耳后（PA）驱动线定位是Jarvik 2000 FlowMaker左心室辅助装置的一个特定特征。我们应用了多项技术改进措施来优化PA植入。在此，我们展示并讨论这些改进。我们回顾性分析了在我们机构植入Jarvik 2000的所有患者。描述了不同的PA植入技术。进行了机器学习分析以评估驱动线感染的决定因素。2008年12月至2017年12月，我们机构有62例患者植入了Jarvik 2000。24例患者（39%）通过“问号形”切口进行PA连接，18例（29%）采用“C形”切口，10例（16%）采用“垂直切口”，10例（16%）采用“正交切口”。植入技术对驱动线感染具有高度预测性。采用后两种技术处理的病例中，驱动线感染率在数值上较低。在经历了不同的植入技术后，我们提出并建议采用“正交切口”以最大化Jarvik 2000耳后驱动线的优势。
