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细胞外基质支架对左心室辅助装置患者 driveline 感染率的影响

Impact of extracellular matrix scaffold on driveline infection rate in patients with left ventricular assist devices.

作者信息

Akay Mehmet H, Jezovnik Mateja K, Radovancevic Rajko, Salas de Armas Ismael A, Aponte Maria Patarroyo, Jumean Marwan, Patel Manish K, Patel Jayeshkumar, Kar Biswajit, Gregoric Igor D

机构信息

Department of Advanced Cardiopulmonary Therapies and Transplantation, The University of Texas Health Science Center at Houston, Houston, Tex.

出版信息

JTCVS Open. 2025 Apr 15;25:200-205. doi: 10.1016/j.xjon.2025.03.029. eCollection 2025 Jun.

Abstract

OBJECTIVE

Left ventricular assist device (LVAD) implantation is a life-saving procedure for patients with advanced heart failure. However, postimplantation complications such as driveline infections (DLIs) can significantly affect patient outcomes. We assessed whether placing an extracellular matrix (ECM) scaffold around the driveline during LVAD implantation reduces the incidence of DLIs in patients with LVADs.

METHODS

This retrospective observational study included 196 consecutive patients with LVADs between January 2018 and June 2022. We compared the data of patients who received ECM implantation during LVAD implantation (ECM group, n = 69) with those who did not (control group, n = 127).

RESULTS

During the study period, 24 of 196 (12.2%) patients with LVADs developed a DLI. Patients who underwent ECM placement exhibited a significantly lower incidence of DLIs than those in the control group (ECM 3/69 vs control 21/127; = .012).

CONCLUSIONS

Patients who received ECM implantation at the time of LVAD implantation had a significantly lower rate of DLIs than patients who did not receive ECM around the driveline. These results suggest that ECM may be a valuable adjunctive strategy to reduce the risk of DLIs in LVAD recipients.

摘要

目的

对于晚期心力衰竭患者,植入左心室辅助装置(LVAD)是一种挽救生命的手术。然而,植入后并发症如导线感染(DLI)会显著影响患者预后。我们评估了在LVAD植入期间在导线周围放置细胞外基质(ECM)支架是否能降低LVAD患者发生DLI的发生率。

方法

这项回顾性观察研究纳入了2018年1月至2022年6月期间连续的196例LVAD患者。我们比较了LVAD植入期间接受ECM植入的患者(ECM组,n = 69)和未接受ECM植入的患者(对照组,n = 127)的数据。

结果

在研究期间,196例LVAD患者中有24例(12.2%)发生了DLI。接受ECM植入的患者发生DLI的发生率显著低于对照组(ECM组3/69 vs对照组21/127;P = 0.012)。

结论

LVAD植入时接受ECM植入的患者发生DLI的发生率显著低于导线周围未接受ECM植入的患者。这些结果表明,ECM可能是一种有价值的辅助策略,可降低LVAD接受者发生DLI的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19af/12230552/7d5ab20dabcc/fx1.jpg

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