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对一个HVAD™流出道移植物假性动脉瘤进行血管内支架置入术,该假性动脉瘤对假体的柔软部分施加压迫和扭结狭窄。

Endovascular stenting of an HVAD™ outflow graft pseudoaneurysm that exerts compression and kinking stenosis on the soft portion of the prosthesis.

作者信息

Elbayomi Mohamed, Weyand Michael, Uder Michael, May Matthias S, Steger Katrin, Roth Jan-Peter, Tandler Rene

机构信息

Department of Cardiac Surgery Friedrich-Alexander-University Erlangen-Nuremberg Erlangen Germany.

Department of Radiology Friedrich-Alexander-University Erlangen-Nuremberg Erlangen Germany.

出版信息

Clin Case Rep. 2023 May 18;11(5):e7349. doi: 10.1002/ccr3.7349. eCollection 2023 May.

DOI:10.1002/ccr3.7349
PMID:37215974
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10196405/
Abstract

KEY CLINICAL MESSAGE

Complex presentations of MCS patients may necessitate a multidisciplinary approach involving HF cardiologists, CT surgeons, advanced cardiac imagers, and interventional cardiologists in order to define the optimal management strategy.

ABSTRACT

Left ventricle assist devices (LVADs) provide life-sustaining treatment for patients with terminal heart failure, but their intricacy allows for complications. One complication is LVAD outflow graft obstruction due to the graft's intraluminal thrombus or extraluminal compression. It may be treated endovascularly with stenting. We report an endovascular stenting of an outflow tract in HVAD™ (HeartWare Inc.) due to a pseudoaneurysm causing compression and kinking stenosis.

摘要

关键临床信息

对于多系统萎缩(MCS)患者的复杂病情,可能需要多学科方法,包括心力衰竭心脏病专家、心胸外科医生、高级心脏影像专家和介入心脏病专家,以确定最佳管理策略。

摘要

左心室辅助装置(LVADs)为终末期心力衰竭患者提供维持生命的治疗,但因其复杂性可能引发并发症。其中一种并发症是LVAD流出道移植物阻塞,原因是移植物管腔内血栓形成或管腔外受压。可通过血管内支架置入术进行治疗。我们报告了一例因假性动脉瘤导致压迫和扭结狭窄而对HeartWare公司的HVAD™流出道进行血管内支架置入的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddbd/10196405/343e06ba01e8/CCR3-11-e7349-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddbd/10196405/0625e5191373/CCR3-11-e7349-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddbd/10196405/9fd697357b1c/CCR3-11-e7349-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddbd/10196405/24aa30f43173/CCR3-11-e7349-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddbd/10196405/6480e83b5350/CCR3-11-e7349-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddbd/10196405/c124c246a61f/CCR3-11-e7349-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddbd/10196405/343e06ba01e8/CCR3-11-e7349-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddbd/10196405/0625e5191373/CCR3-11-e7349-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddbd/10196405/9fd697357b1c/CCR3-11-e7349-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddbd/10196405/24aa30f43173/CCR3-11-e7349-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddbd/10196405/6480e83b5350/CCR3-11-e7349-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddbd/10196405/c124c246a61f/CCR3-11-e7349-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddbd/10196405/343e06ba01e8/CCR3-11-e7349-g002.jpg

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本文引用的文献

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A multicenter evaluation of external outflow graft obstruction with a fully magnetically levitated left ventricular assist device.一项使用完全磁悬浮左心室辅助装置评估外部流出道阻塞的多中心研究。
J Thorac Cardiovasc Surg. 2024 Apr;167(4):1322-1330.e6. doi: 10.1016/j.jtcvs.2022.09.051. Epub 2022 Oct 3.
2
Retrograde washout of prepump LVAD thrombosis in a patient on HeartWare™ support.经心卫士(HeartWare)™ 辅助下的患者泵前左心室辅助装置血栓逆行冲洗
J Card Surg. 2022 Oct;37(10):3440-3442. doi: 10.1111/jocs.16813. Epub 2022 Jul 27.
3
Interventional Procedures for Left Ventricular Assist Device-Associated Complications.
介入治疗左心室辅助装置相关并发症。
ASAIO J. 2022 Nov 1;68(11):1332-1338. doi: 10.1097/MAT.0000000000001674. Epub 2022 Feb 15.
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HeartWare HVAD Market Withdrawal and Impact on the Pediatric Field.HeartWare心室辅助装置(HVAD)的市场撤出及其对儿科领域的影响。
ASAIO J. 2021 Aug 1;67(8):825-826. doi: 10.1097/MAT.0000000000001538.
5
An interventional approach to left ventricular assist device outflow graft obstruction.左心室辅助装置流出道移植物梗阻的介入治疗方法。
Catheter Cardiovasc Interv. 2021 Nov 1;98(5):969-974. doi: 10.1002/ccd.29556. Epub 2021 Feb 15.
6
Survival outcomes of stenting outflow graft stenosis in continuous-flow left ventricular assist devices: a systematic review.连续性血流左心室辅助装置流出道移植物狭窄支架置入术后的生存结局:系统评价。
Heart Fail Rev. 2020 Nov;25(6):985-992. doi: 10.1007/s10741-019-09888-w.
7
Left Ventricular Assist Device Outflow Graft Obstruction: A Case Series.左心室辅助装置流出道移植物阻塞:病例系列。
ASAIO J. 2020 Jun;66(6):657-662. doi: 10.1097/MAT.0000000000001060.
8
Third INTERMACS Annual Report: the evolution of destination therapy in the United States.第三届 INTERMACS 年度报告:美国心脏移植终点治疗的演变。
J Heart Lung Transplant. 2011 Feb;30(2):115-23. doi: 10.1016/j.healun.2010.12.001.
9
Use of a continuous-flow device in patients awaiting heart transplantation.在等待心脏移植的患者中使用连续流装置。
N Engl J Med. 2007 Aug 30;357(9):885-96. doi: 10.1056/NEJMoa067758.