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腋动脉移植物血栓切除术后置入Impella血流泵:更换腋动脉Impella的技术要点

Impella flow pump reinsertion after axillary graft thrombectomy: Technical points in replacing axillary Impella.

作者信息

Haddad Osama, Jacob Samuel, Ung Ryan L, Goswami Rohan M, Patel Parag C, Pham Si M, Sareyyupoglu Basar

机构信息

Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, FL, USA.

Departments of Transplantation, Advanced Heart Failure and Transplant Cardiology, Mayo Clinic, Jacksonville, FL, USA.

出版信息

SAGE Open Med Case Rep. 2021 Jul 12;9:2050313X211032401. doi: 10.1177/2050313X211032401. eCollection 2021.

DOI:10.1177/2050313X211032401
PMID:34290874
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8278451/
Abstract

Axillary Impella devices are increasingly employed for long-term support of patients with systolic heart failure and shock. Axillary access allows for awake support and ambulation, which carries an inherent risk of disconnection or malposition. We report a series of two cases where device replacement due to dysfunction and malposition can be completed safely through the original axillary graft using axillary graft thrombectomy, given that the clot burden could be a major source of morbidity to the patient.

摘要

腋动脉置入式Impella装置越来越多地用于对收缩性心力衰竭和休克患者的长期支持。经腋动脉置入可实现清醒状态下的支持和下床活动,但存在装置断开连接或位置不当的固有风险。我们报告了两例病例,鉴于血栓负荷可能是患者发病的主要原因,通过腋动脉移植物血栓切除术,可经原腋动脉移植物安全完成因功能障碍和位置不当而进行的装置更换。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b7b/8278451/4184ea6753da/10.1177_2050313X211032401-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b7b/8278451/b64ac62ce7cf/10.1177_2050313X211032401-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b7b/8278451/638e292aa36d/10.1177_2050313X211032401-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b7b/8278451/4184ea6753da/10.1177_2050313X211032401-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b7b/8278451/b64ac62ce7cf/10.1177_2050313X211032401-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b7b/8278451/638e292aa36d/10.1177_2050313X211032401-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b7b/8278451/4184ea6753da/10.1177_2050313X211032401-fig3.jpg

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本文引用的文献

1
Adverse events and modes of failure related to the Impella percutaneous left ventricular assist devices: a retrospective analysis of the MAUDE database.与Impella经皮左心室辅助装置相关的不良事件及故障模式:MAUDE数据库的回顾性分析
EuroIntervention. 2019 May 20;15(1):44-46. doi: 10.4244/EIJ-D-18-01021.
2
Safe Exchange of a Transfemoral Impella Pump.经股动脉Impella泵的安全交换
Cardiovasc Revasc Med. 2019 Sep;20(9):827-828. doi: 10.1016/j.carrev.2018.12.006. Epub 2018 Dec 19.
3
Right Axillary Artery Conduit Is a Safe and Reliable Access for Implantation of Impella 5.0 Microaxial Pump.
心脏移植患者应用 Impella 5.5 心室辅助装置桥接的短期结局。
ESC Heart Fail. 2023 Aug;10(4):2298-2306. doi: 10.1002/ehf2.14391. Epub 2023 May 3.
右腋动脉导管是用于植入Impella 5.0微轴流泵的安全可靠的入路。
Ann Vasc Surg. 2019 Jan;54:54-59. doi: 10.1016/j.avsg.2018.10.004. Epub 2018 Oct 17.
4
Current and Future Percutaneous Strategies for the Treatment of Acute and Chronic Heart Failure.急性和慢性心力衰竭治疗的当前及未来经皮策略
Rev Esp Cardiol (Engl Ed). 2017 May;70(5):382-390. doi: 10.1016/j.rec.2016.12.008. Epub 2017 Jan 30.
5
Short-term mechanical circulatory support with the Impella 5.0 device for cardiogenic shock at La Pitié-Salpêtrière.在拉皮提耶尔-萨尔佩特里埃医院使用Impella 5.0设备对心源性休克进行短期机械循环支持。
Eur Heart J Acute Cardiovasc Care. 2017 Feb;6(1):87-92. doi: 10.1177/2048872616633877. Epub 2016 Sep 20.
6
Thirty-five day Impella 5.0 support via right axillary side graft cannulation for acute cardiogenic shock.经右侧腋部侧支移植插管使用Impella 5.0进行35天的急性心源性休克支持治疗。
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The right axillary artery approach for the Impella Recover LP 5.0 microaxial pump.用于Impella Recover LP 5.0微轴流泵的右腋动脉入路
Ann Thorac Surg. 2008 Apr;85(4):1468-70. doi: 10.1016/j.athoracsur.2007.09.017.