The Second Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan.
Department of Cardiovascular Surgery, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.
J Artif Organs. 2021 Sep;24(3):372-376. doi: 10.1007/s10047-020-01232-6. Epub 2021 Jan 3.
We experienced two refractory cardiogenic shock patients receiving veno-arterial extracorporeal membrane oxygenation and Impella percutaneous left ventricular assist device (ECPELLA). TVAD score, which was originally proposed to predict one-year mortality following left ventricular assist device implantation using four objective parameters, was retrospectively calculated using data of day 3 following ECPELLA initiations. One patient with estimated intermediate risk could achieve successful explantation of ECPELLA, whereas another patient with estimated high risk was expired despite explantation of extracorporeal membrane oxygenation. TVAD score might be a useful tool to risk stratify and construct next strategy (i.e., bridge to recovery or bridge to more intensive therapy) for those with ECPELLA, although further studies are warranted to validate this hypothesis.
我们遇到了两位接受静脉-动脉体外膜肺氧合和 Impella 经皮左心室辅助装置（ECPELLA）治疗的难治性心源性休克患者。TVAD 评分最初是为了预测使用四个客观参数的左心室辅助装置植入后的一年死亡率而提出的，使用在启动 ECPELLA 后的第 3 天的数据进行回顾性计算。一位估计为中度风险的患者成功地进行了 ECPELLA 的除颤，而另一位估计为高风险的患者尽管进行了体外膜氧合的除颤，最终仍死亡。TVAD 评分可能是一种有用的工具，可以对接受 ECPELLA 治疗的患者进行风险分层，并制定下一步策略（即恢复桥接或更强化治疗桥接），尽管需要进一步的研究来验证这一假设。
