Abdelkader Abdalla Eltayeb A, Ilonze Onyedika J, Guglin Maya
Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
JACC Case Rep. 2025 Jan 15;30(2):102801. doi: 10.1016/j.jaccas.2024.102801.
Implantable hemodynamic devices like the CardioMEMS HF System are commonly used to manage fluid status in patients with heart failure (HF) by measuring pulmonary pressures. Although CardioMEMS has been shown to reduce HF hospitalizations, rare complications (eg, device endothelialization) can occur and warrant clinical attention. A 67-year-old woman with HF with preserved ejection fraction and group 2 pulmonary hypertension experienced recurrent HF exacerbations. Despite optimal therapy, she was not a candidate for advanced HF therapies. The CardioMEMS device, initially effective for fluid management, showed dampened waveforms due to endothelialization, leading to reimplantation. Endothelialization is a rare but significant complication that can dampen pressure waveforms. Proper placement in vessels larger than 7 mm and careful monitoring of waveforms can help manage this issue. Device recalibration can usually address most cases; however, reimplantation may be required.
像CardioMEMS HF系统这样的可植入式血流动力学设备通常用于通过测量肺压来管理心力衰竭(HF)患者的液体状态。尽管CardioMEMS已被证明可减少HF住院率,但仍可能发生罕见并发症(如设备内皮化),值得临床关注。一名67岁射血分数保留的HF和2级肺动脉高压女性经历了反复的HF加重。尽管进行了最佳治疗,但她不适合接受晚期HF治疗。CardioMEMS设备最初对液体管理有效,但由于内皮化显示波形衰减,导致再次植入。内皮化是一种罕见但重要的并发症,可使压力波形衰减。将设备正确放置在直径大于7毫米的血管中并仔细监测波形有助于解决这个问题。设备重新校准通常可以解决大多数情况;然而,可能需要再次植入。