Division of Cardiovascular Medicine, Department of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA.
Division of Cardiothoracic Surgery, Virginia Commonwealth University, Richmond, Virginia, USA.
Catheter Cardiovasc Interv. 2022 Jul;100(1):169-174. doi: 10.1002/ccd.30230. Epub 2022 May 17.
To assess the outcomes of a single-center experience with percutaneous left ventricular assist device (LVAD) decommissioning.
Patients with LVADs may eventually require their removal, either due to recovery of left ventricular function or recurrent complications. Traditionally, withdrawal of LVAD support has been managed with surgical device explantation, which carries significant procedural risks. Transcatheter LVAD decommissioning, with outflow graft occlusion and driveline transection, has recently been described as an alternative to surgical removal.
Here, we report on a retrospective cohort of five consecutive cases treated with transcatheter LVAD decommissioning.
The procedure was effective in all cases, and no patient experienced procedure-related complications. At midterm follow-up, the three patients who had myocardial function recovery were alive and had not experienced heart failure-related symptoms or complications.
Percutaneous LVAD decommissioning appears to be a safe and effective approach to LVAD treatment discontinuation.
评估单中心经皮左心室辅助装置（LVAD）撤机的结果。
LVAD 患者最终可能需要移除 LVAD，原因可能是左心室功能恢复或反复出现并发症。传统上，LVAD 支持的撤机是通过外科器械取出来管理的，但这会带来重大的手术风险。最近，经导管 LVAD 撤机已被描述为一种替代外科移除的方法，通过流出道移植物闭塞和驱动线切断来实现。
在这里，我们报告了五例连续接受经导管 LVAD 撤机治疗的回顾性队列研究。
该手术在所有病例中均有效，且无患者发生与手术相关的并发症。在中期随访中，心肌功能恢复的 3 例患者仍然存活，且未出现心力衰竭相关症状或并发症。
经皮 LVAD 撤机似乎是一种安全有效的 LVAD 治疗终止方法。
