Guo Aaron, Subramanian Melanie P, Vader Justin, Lavine Kory, Schilling Joel, Hartupee Justin, Kotkar Kunal, Itoh Akinobu
Division of Cardiothoracic Surgery, Department of Surgery, Washington University in St Louis School of Medicine, St Louis, Missouri.
Division of Cardiovascular Diseases, Department of Medicine, Washington University School of Medicine in St Louis, St Louis, Missouri.
Ann Thorac Surg Short Rep. 2022 Oct 29;1(1):191-193. doi: 10.1016/j.atssr.2022.10.015. eCollection 2023 Mar.
Restrictive or hypertrophic cardiomyopathy presents a challenge to left ventricular assist device placement because of the small left ventricle cavity. Cases have described inflow cannulation of the HeartWare HVAD by expanded polytetrafluoroethylene conduit through the atrial septum to the left atrium. We applied this technique to an adult man with restrictive cardiomyopathy and pulmonary hypertension using the HeartMate 3, which successfully supported the patient and led to significant reduction in pulmonary artery pressure. He received a transplant 3 months later without complications. For select patients, left atrial conduit for HeartMate 3 inflow is a feasible alternative to conventional apical cannulation.
限制性或肥厚性心肌病因左心室腔小，给左心室辅助装置的植入带来挑战。已有病例描述通过经房间隔的膨体聚四氟乙烯导管将HeartWare HVAD流入插管至左心房。我们将此技术应用于一名患有限制性心肌病和肺动脉高压的成年男性，使用的是HeartMate 3，该装置成功支持了患者，并使肺动脉压力显著降低。3个月后他接受了移植，未出现并发症。对于特定患者，HeartMate 3流入的左心房导管是传统心尖插管的可行替代方案。
