Department of Cardiovascular Surgery, The University of Tokyo Hospital, Tokyo, Japan.
J Artif Organs. 2023 Dec;26(4):326-329. doi: 10.1007/s10047-023-01380-5. Epub 2023 Jan 23.
Implantation of continuous-flow left ventricular assist device in a narrow lumen is technically challenging to secure an optimal support. We experienced a patient with the transposition of the great arteries after the Senning procedure who was initially implanted with Jarvik 2000®. She presented with worsening heart failure symptoms 2 years after implanting Jarvik 2000®. We assumed that the inflow cannula was stuck in the highly developed trabeculae on the interventricular septum, which disturbed the VAD to maintain an expected support. After converting to the EVAHEART® 2, we successfully obtained an adequate inflow. We consider that the tipless cannula of EVAHEART® 2 is the most suitable when there is no sufficient room to place a conventional inflow cannula in the systemic ventricle.
将连续血流左心室辅助装置植入到狭小的腔室中,技术上很难确保获得最佳的支持。我们遇到了一位大动脉转位患者,她在 Senning 手术后最初植入了 Jarvik 2000®。在植入 Jarvik 2000® 2 年后,她出现了心力衰竭症状恶化的情况。我们推测流入管卡在了室间隔上高度发达的小梁之间,这干扰了 VAD 以维持预期的支持。在转换为 EVAHEART® 2 后,我们成功获得了足够的流入。当在体腔中没有足够的空间放置传统的流入管时,我们认为 EVAHEART® 2 的无尖端管是最合适的。