Division of Cardiovascular Medicine, University of Louisville, Louisville, Kentucky.
Catheter Cardiovasc Interv. 2021 Jan 1;97(1):152-156. doi: 10.1002/ccd.29190. Epub 2020 Aug 19.
Owing to the growing population with end stage heart failure, the use of left ventricular assist devices (LVADs) have become more widely accepted. Although survival has improved with newer generation LVADs, multiple complications including pump failure due to outflow graft obstruction have become more clinically relevant. Patients with this complication will present with heart failure symptoms due to inadequate unloading of the left ventricle by LVAD. This rare complication often requires open surgical repair in an already high-risk patient population. Alternative means to relieve the obstruction via percutaneous intervention has been described in rare cases. We present two unique cases of LVAD outflow graft obstruction which were percutaneously treated successfully. This article illustrates a potential treatment strategy for outflow graft obstruction with stenting as an alternative to open-heart surgery.
由于终末期心力衰竭患者人数不断增加，左心室辅助装置（LVAD）的使用已被更广泛地接受。尽管新一代 LVAD 的生存率有所提高，但由于流出道移植物阻塞导致的泵衰竭等多种并发症变得更加具有临床相关性。由于 LVAD 未能充分减轻左心室的负荷，患有这种并发症的患者会出现心力衰竭症状。这种罕见的并发症在本就高危的患者群体中通常需要进行开放性心脏手术修复。在极少数情况下，通过经皮介入治疗来缓解阻塞的方法已经有所描述。我们介绍了两例成功经皮治疗的 LVAD 流出道移植物阻塞的独特病例。本文展示了一种通过支架置入术治疗流出道移植物阻塞的潜在治疗策略，这是一种替代心脏直视手术的方法。
