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因腹部驱动线感染,将左心室辅助装置更换为带耳后电缆的Jarvik 2000泵。

Pump Exchange from a Left Ventricular Assist Device to a Jarvik 2000 with a Postauricular Cable Due to Abdominal Driveline Infection.

作者信息

Kishimoto Yuichiro, Yoshikawa Yasushi, Onohara Takeshi, Kumagai Kunitaka, Sakaguchi Yuki, Sumi Naoki, Kishimoto Nozomi, Ikeda Yosuke, Yoshikawa Yuki, Yamane Kazuma, Nishimura Motonobu

机构信息

Department of Cardiovascular Surgery, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan and.

Kawasaki Hospital, Kobe 652-0042, Japan.

出版信息

Yonago Acta Med. 2023 Jul 31;66(3):389-393. doi: 10.33160/yam.2023.08.007. eCollection 2023 Aug.

Abstract

Driveline infection in patients with implantable left ventricular assist devices (LVAD) remains common and crucial. Once a driveline exit-site infection reaches the LVAD component, radical treatment such as LVAD exchange may become necessary, although the clinical results are unsatisfactory. The Jarvik 2000 device, which utilizes a postauricular cable, allows the driveline to exit the body behind the ear (postauricular) instead of through an abdominal site. Here, we report the case of a patient who had awaited heart transplantation for more than 6 years and had a critical driveline infection that almost reached the LVAD pump. The patient underwent a pump exchange using the Jarvik 2000 with a postauricular cable, with excellent results. It is a useful replacement option for patients with abdominal driveline infections, owing to its small pump pocket and the availability of an alternative pathway for the driveline.

摘要

植入式左心室辅助装置(LVAD)患者的 driveline 感染仍然很常见且至关重要。一旦 driveline 出口部位感染累及 LVAD 组件,可能就需要进行如更换 LVAD 等根治性治疗,尽管临床效果并不理想。Jarvik 2000 装置采用耳后电缆,使 driveline 从耳后(耳后)而非腹部部位穿出身体。在此,我们报告一例等待心脏移植超过 6 年且发生严重 driveline 感染、几乎累及 LVAD 泵的患者病例。该患者使用带有耳后电缆的 Jarvik 2000 进行了泵更换,效果极佳。由于其泵腔较小且 driveline 有替代通路,对于腹部 driveline 感染患者而言,它是一种有用的替代选择。

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本文引用的文献

1
Complex HeartWare left ventricular assist device infection treated with pump exchange: clinical alert for the driveline location.
J Artif Organs. 2021 Sep;24(3):377-381. doi: 10.1007/s10047-020-01245-1. Epub 2021 Jan 13.
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FDG PET/CT for Early Detection and Localization of Left Ventricular Assist Device Infection: Impact on Patient Management and Outcome.
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