Heart:作为移植过渡的左心室辅助装置患者的生存率及治疗预后

2018-08-21 xiangting MedSci原创

在重度心衰且预后极差的患者人群中,使用植入式LVAD支持使得四分之一的患者在3年内接受了心脏移植。

这项研究旨在探讨英国使用植入式左心室辅助装置(LVAD)作为心脏移植过渡患者的生存率和预后。

纳入2007年1月至2013年12月31日期间接受HeartMate II或HVAD作为首个长期LVAD的所有成年患者(n=342),并于2015年11月从英国心室辅助装置(VAD)数据库中提取这些患者的数据。预后分析包括使用LVAD的生存率、列入紧急移植名单的时间、心脏移植和并发症,其中包括需要更换泵的并发症。

112名患者使用Thoratec HeartMate II支持,230名患者使用HeartWare HVAD支持。中位支持时间为534天。在研究期间,81名患者需要加入英国紧急心脏移植名单。在342名患者中,85名(24.8%)接受了心脏移植,其中63名在紧急名单上。30天生存率为88.9%,而LVAD植入后3年的总患者生存率为49.6%。LVAD支持期间有156名患者(46%)死亡;VAD支持期间最常见的死因是脑血管意外。在任何结局上两种装置均不存在显著差异。

在重度心衰且预后极差的患者人群中,使用植入式LVAD支持使得四分之一的患者在3年内接受了心脏移植。该队列的总生存率约为50%。随着技术进步和LVAD后管理的改善,预后将会得到进一步改善。

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    2018-08-23 zhaojie88
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    2018-08-23 slcumt

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