更换为HeartMate 3左心室辅助装置：既往泵型号对临床结局的影响。
Device Exchange to HeartMate 3 LVAD: Impact of Previous Pump Model on Clinical Outcomes.
作者信息
Coyle Laura, Chau Vinh Q, Gallagher Colleen, Hicks Stephen D, Narang Nikhil, Pappas Patroklos S, Tatooles Antone J
机构信息
Advocate Heart Institute, Advocate Christ Medical Center, Oak Lawn, Illinois.
Cardiothoracic and Vascular Surgical Associates, SC, Advocate Christ Medical Center, Oak Lawn, Illinois.
出版信息
Ann Thorac Surg Short Rep. 2023 May 27;1(3):522-525. doi: 10.1016/j.atssr.2023.05.002. eCollection 2023 Sep.
BACKGROUND
We describe our clinical experience performing device exchange from a HeartMate II (HM2) or HVAD to a HeartMate 3 (HM3) left ventricular assist device.
METHODS
A single-center retrospective study was performed of all patients (N = 14) who underwent a left ventricular assist device exchange from HM2 (n = 7) or HVAD (n = 7) to HM3 between October 2018 and October 2021. The primary outcome was 1-year overall survival, and secondary outcomes included adverse events through discharge.
RESULTS
All patients (median age, 59 years; 29% female) were destination therapy and required urgent device exchange because of pump failure. Although statistically insignificant, the 1-year overall survival was worse in the HVAD to HM3 group compared with the HM2 to HM3 cohort (57% vs 100%, respectively; = .19). The HVAD to HM3 group also experienced significantly more acute right-sided heart failure requiring right ventricular assist device support (71% vs 0%; = .02), ventilator days (11 days vs 1 day; = .001), and reoperation (100% vs 14%; = .004).
CONCLUSIONS
Patients being considered for device exchange from HVAD to HM3 may have a more complicated clinical course compared with HM2 to HM3 patients.
背景
我们描述了将HeartMate II（HM2）或HeartWare心室辅助装置（HVAD）更换为HeartMate 3（HM3）左心室辅助装置的临床经验。
方法
对2018年10月至2021年10月期间所有接受从HM2（n = 7）或HVAD（n = 7）更换为HM3的左心室辅助装置的患者（N = 14）进行了单中心回顾性研究。主要结局是1年总生存率，次要结局包括出院前的不良事件。
结果
所有患者（中位年龄59岁；29%为女性）均为目标治疗，因泵衰竭需要紧急更换装置。虽然无统计学意义，但与HM2至HM3队列相比，HVAD至HM3组的1年总生存率较差（分别为57%和100%；P = 0.19）。HVAD至HM3组还出现了明显更多的急性右侧心力衰竭，需要右心室辅助装置支持（71%对0%；P = 0.02）、呼吸机使用天数（11天对1天；P = 0.001）和再次手术（100%对14%；P = 0.004）。
结论
与从HM2更换为HM3的患者相比，考虑从HVAD更换为HM3的患者可能有更复杂的临床过程。
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