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左心室辅助装置支持期间因主动脉瓣关闭不全导致的急性心力衰竭伴单侧肺水肿

Acute Heart Failure With Unilateral Pulmonary Edema Due to Aortic Insufficiency During LVAD Support.

作者信息

Marsela Enklajd, Saeed Omar, Patel Snehal R, Jorde Ulrich P

机构信息

Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.

出版信息

JACC Case Rep. 2024 Oct 2;29(19):102584. doi: 10.1016/j.jaccas.2024.102584.

Abstract

Unilateral pulmonary edema (UPE) is a rare manifestation of cardiogenic pulmonary edema that is often confused with other causes of unilateral pulmonary infiltrates. A 47-year-old female with a HeartWare left ventricular assist device (LVAD) presented with dyspnea and UPE. Right heart catheterization revealed inadequate left ventricular unloading in the setting of aortic insufficiency and facilitated LVAD speed adjustment leading to resolution of symptoms. Timely diagnosis of UPE is critical because it is related to an independent increased risk of mortality, likely due to initial misdiagnosis and delayed proper treatment. The increasing use of LVADs in patients with advanced heart failure necessitates a thorough understanding of potential device complications and their management.

摘要

单侧肺水肿(UPE)是心源性肺水肿的一种罕见表现,常与单侧肺部浸润的其他病因相混淆。一名植入HeartWare左心室辅助装置(LVAD)的47岁女性出现呼吸困难和UPE。右心导管检查显示在主动脉瓣关闭不全的情况下左心室卸载不足,通过调整LVAD速度症状得以缓解。及时诊断UPE至关重要,因为它与独立的死亡风险增加有关,可能是由于最初的误诊和延迟的恰当治疗。晚期心力衰竭患者中LVAD的使用日益增加,这就需要全面了解潜在的装置并发症及其管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e03/11522743/8819403da09d/ga1.jpg

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