Thaitirarot Chokanan, Shapiro Leonard M, Lewis Clive, Parameshwar Jayan, Tsui Steven S L, Pettit Stephen J
Transplant Unit, Royal Papworth Hospital, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.
Cardiology Centre, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand.
JHLT Open. 2024 Oct 23;7:100169. doi: 10.1016/j.jhlto.2024.100169. eCollection 2025 Feb.
Ten years have passed since we reported percutaneous decommissioning of an implantable left ventricular assist device (LVAD) using 2 Amplatzer vascular plugs in a 17-year-old male who was bridged to recovery after 22 months of LVAD support. While his left ventricular (LV) dimensions never completely normalized and there has been persistent mild impairment of LV systolic function, the patient remains free of heart failure symptoms and his natriuretic peptide level has been well suppressed on guideline-directed medical therapy. He is anticoagulated with Warfarin. There have been no adverse events relating to either the decommissioned LVAD or the percutaneous driveline remnant, or anticoagulation. This case highlights the potential for long-term survival without adverse events in individuals who are left with a redundant implantable LVAD after successful percutaneous withdrawal of mechanical circulatory support.
自从我们报道了在一名17岁男性患者中使用2个Amplatzer血管封堵器经皮停用植入式左心室辅助装置（LVAD）以来，已经过去了十年。该患者在接受LVAD支持22个月后过渡到康复状态。虽然他的左心室（LV）尺寸从未完全恢复正常，并且LV收缩功能一直存在轻度损害，但该患者仍无心力衰竭症状，并且在指南指导的药物治疗下，他的利钠肽水平得到了很好的抑制。他使用华法林进行抗凝治疗。与停用的LVAD、经皮驱动线残余物或抗凝治疗均未发生不良事件。该病例突出了在成功经皮撤除机械循环支持后，体内留有多余植入式LVAD的个体实现长期生存且无不良事件的可能性。
