Section of Internal and Cardiopulmonary Medicine, Faculty of Medicine, University of Ferrara, Ferrara, Italy.
Cardiovascular Diagnosis and Endoluminal Interventions Unit, Rovigo General Hospital, Rovigo, Italy.
Heart Fail Rev. 2020 Nov;25(6):965-972. doi: 10.1007/s10741-019-09884-0.
Mechanical ventricular support with left ventricular assist device (LVAD) has emerged as a durable and safe therapy, both as bridge-to-transplant (BTT) or destination therapy (DT), in patients with advanced heart failure (HF). However, the occurrence of pump thrombosis (PT) still represents a serious complication, especially when LVADs of first or second generation are implanted. During the latest years, some investigations have recognized the occurrence of cavitation, evidenced through transthoracic echocardiography (TTE), as a potential early and indirect sign of PT. In the present manuscript, we reviewed the available data on the occurrence of cavitation in LVAD patients as an early potential marker of PT, also presenting the hemodynamic mechanisms involved.
机械心室辅助装置(LVAD)的机械性心室支持已经成为一种耐用且安全的治疗方法,无论是作为桥接移植(BTT)还是终末期治疗(DT),都适用于晚期心力衰竭(HF)患者。然而,泵血栓形成(PT)的发生仍然是一种严重的并发症,尤其是在植入第一代或第二代 LVAD 时。在最近几年,一些研究已经认识到空化的发生,通过经胸超声心动图(TTE)证实,这是空化作为 PT 的潜在早期和间接标志。在本手稿中,我们回顾了 LVAD 患者中发生空化作为 PT 的早期潜在标志物的现有数据,同时还介绍了涉及的血流动力学机制。