Division of Cardiovascular Surgery and Department of Cardiopulmonary Transplantation and Center for Cardiac Support, Texas Heart Institute, The University of Texas School of Public Health; Houston, Texas 77030.
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, The University of Texas School of Public Health; Houston, Texas 77030.
Tex Heart Inst J. 2020 Aug 1;47(4):325-328. doi: 10.14503/THIJ-19-7193.
We report the long-term survival of a 46-year-old man supported with a HeartMate II continuous-flow left ventricular assist device after complex repair of a bicuspid aortic valve, anomalous left main coronary artery, and dilated aorta. He has been maintained on an anticoagulation regimen of warfarin and low-dose aspirin without problems for 10 years, during which he has worked continuously and productively. Device flow has been kept at 10,000 rpm. Possible contributors to this long-term success include proper alignment of the device inflow cannula, pericardial patch closure of the left ventricular outflow tract, and, notably, the remarkable freedom from mechanical failure of the continuous-flow left ventricular assist device. Whether the higher flow rate produced by the pericardial patch closure contributes to pump longevity is unknown and merits further investigation.
我们报告了一例 46 岁男性患者的长期生存情况，该患者在接受二尖瓣瓣叶裂、左冠状动脉主干异常和升主动脉扩张的复杂修复后，使用 HeartMate II 左心室辅助装置持续辅助。患者接受华法林和低剂量阿司匹林抗凝治疗，10 年来未出现任何问题，在此期间，他一直持续、高效地工作。装置流量保持在 10000rpm。可能促成这一长期成功的因素包括装置流入管的正确对准、左心室流出道的心包膜补片封闭，以及特别是连续流左心室辅助装置的显著机械故障。心包补片封闭产生的更高流量是否有助于延长泵的寿命尚不清楚，值得进一步研究。
