Bratisl Lek Listy. 2021;122(6):371-378. doi: 10.4149/10.4149/BLL_2021_062.
Mechanical circulatory support is an established therapy in end-stage heart failure. The EUROMACS registry was created to promote research in these patients. The aim of this report was to present our 12 year experience with the durable mechanical circulatory support devices and compare it with the EUROMACS registry.
Data from the entire EUROMACS registry from January 2011 to April 2019 were included (4704 implantations in 4410 patients). During the 12 years of our experience, until April 2019,125 mechanical support devices were implanted, in 122 patients. We compare patients´ characteristics, operative data and results with the EUROMACS registry and we report the major complications during the observational period.
Primary end-point (death) occurred in 40 (32.8 %) patients in our cohort during the follow-up period, representing the survival rate 75 %, 68 %, and 58 % for 6, 12, 24 months respectively, which compares favourably with the data, reported by the EUROMACS registry, the survival 66 % and 53 % after 1 and 2 years respectively. Cerebrovascular accident occurred in 7 %, a bleeding event in 32 %, significant infection (driveline) in 78 % and a device malfunction in 13 % of the patients. Forty- three patients underwent a heart transplant with hospital and long-term mortality of 11.6 % and 14 % respectively.
Mechanical circulatory support is a valuable therapeutic option with excellent survival rates, nevertheless it is associated with clinically significant complications rates. The direct comparison between our cohort and the EUROMACS registry showed that early implantation strategy and mini invasive approach may improve survival rates and decrease postoperative complications (Tab. 3, Fig. 3, Ref. 16).
机械循环支持是心力衰竭终末期的一种成熟治疗方法。EUROMACS 注册研究旨在促进对这些患者的研究。本报告的目的是介绍我们在耐用型机械循环支持设备方面的 12 年经验，并将其与 EUROMACS 注册研究进行比较。
纳入了 2011 年 1 月至 2019 年 4 月期间整个 EUROMACS 注册研究的数据（4704 例植入，4410 例患者）。在我们 12 年的经验中，截至 2019 年 4 月，共植入 125 例机械辅助装置，涉及 122 例患者。我们将患者的特征、手术数据和结果与 EUROMACS 注册研究进行比较，并报告观察期间的主要并发症。
在我们的队列中，随访期间 40 例（32.8%）患者发生主要终点（死亡），生存率分别为 6、12、24 个月时为 75%、68%和 58%，与 EUROMACS 注册研究报告的 6、12 个月时分别为 66%和 53%的生存率相比具有优势。7%的患者发生了脑血管意外，32%的患者发生了出血事件，78%的患者发生了严重感染（导线），13%的患者发生了设备故障。43 例患者接受心脏移植，院内和长期死亡率分别为 11.6%和 14%。
机械循环支持是一种具有出色生存率的有价值的治疗选择，但它与临床上显著的并发症发生率相关。我们的队列与 EUROMACS 注册研究的直接比较表明，早期植入策略和微创方法可能提高生存率并降低术后并发症（表 3，图 3，参考文献 16）。
