植入 HeartMate 3 心脏辅助装置，重点关注双心室构型。

HeartMate 3 implantation with an emphasis on the biventricular configuration.

机构信息

Department of Cardiothoracic Surgery and Transplantation, The Alfred, Melbourne, Victoria, Australia.

Department of Surgery, Monash University, Melbourne, Victoria, Australia.

出版信息

Artif Organs. 2024 Jun;48(6):655-664. doi: 10.1111/aor.14741. Epub 2024 Mar 8.

DOI:10.1111/aor.14741

PMID:38459775

Abstract

OBJECTIVES

Right ventricular failure following implantation of a durable left ventricular assist device (LVAD) is a major driver of mortality. Reported survival following biventricular (BiVAD) or total artificial heart (TAH) implantation remains substantially inferior to LVAD alone. We report our outcomes with LVAD and BiVAD HeartMate 3 (HM3).

METHODS

Consecutive patients undergoing implantation of an HM3 LVAD between November 2014 and December 2021, at The Alfred, Australia were included in the study. Comparison was made between the BiVAD and LVAD alone groups.

RESULTS

A total of 86 patients, 65 patients with LVAD alone and 21 in a BiVAD configuration underwent implantation. The median age of the LVAD and BiVAD groups was 56 years (Interquartile range 46-62) and 49 years (Interquartile range 37-55), respectively. By 4 years after implantation, 54% of LVAD patients and 43% of BiVAD patients had undergone cardiac transplantation. The incidence of stroke in the entire experience was 3.5% and pump thrombosis 5% (all in the RVAD). There were 14 deaths in the LVAD group and 1 in the BiVAD group. The actuarial survival for LVAD patients at 1 year was 85% and BiVAD patients at 1 year was 95%.

CONCLUSIONS

The application of HM 3 BiVAD support in selected patients appears to offer a satisfactory solution to patients requiring biventricular support.

摘要

目的

永久性左心室辅助装置（LVAD）植入后的右心室衰竭是导致死亡率的主要原因。双心室（BiVAD）或全人工心脏（TAH）植入后的存活率仍然明显低于单独使用 LVAD。我们报告了使用 LVAD 和 BiVAD HeartMate 3（HM3）的结果。

方法

在澳大利亚阿尔弗雷德医院，纳入了 2014 年 11 月至 2021 年 12 月期间接受 HM3 LVAD 植入的连续患者。比较了 BiVAD 和单独 LVAD 组的结果。

结果

共有 86 名患者，65 名患者接受了单独 LVAD 植入，21 名患者接受了 BiVAD 配置植入。LVAD 和 BiVAD 组的中位年龄分别为 56 岁（四分位距 46-62）和 49 岁（四分位距 37-55）。植入后 4 年，54%的 LVAD 患者和 43%的 BiVAD 患者接受了心脏移植。整个经验中的中风发生率为 3.5%，泵血栓形成率为 5%（均在 RVAD 中）。LVAD 组有 14 例死亡，BiVAD 组有 1 例死亡。LVAD 患者的 1 年生存率为 85%，BiVAD 患者的 1 年生存率为 95%。