摘要
目的:研究左心辅助装置(LVAD)TCI HeartMate 1000 IP对终末期心脏病人的救治作用和并发症。方法:总结9例LVAD植入资料。原发病为:扩张型心肌病4例,冠心病4例,先天性主动脉瓣狭窄合并冠心病1例。术前平均射血分数为0.145±0.04。结果:LVAD植入后,心排量指数由术前(1.76±0.50)L·m^2·min^(-1)升至(3.34±0.96)L·m^2·min^(-1)(P<0.05),肺动脉毛细血管嵌顿压由(28.6±4.5)mmHg降至(12.9±4.9)mmHg(P<0.05)。在ICU的天数为:(17.3±15.5)天。LVAD支持时间为平均(66.9±50.9)天。有5例过渡至心脏移植并痊愈出院。死亡4例:3例死于右心衰和呼吸衰竭,1例死于全身衰竭。主要并发症:(1)出血;(2)右心衰;(3)脑栓塞;(4)感染。结论:TCI Heart Mate 1000 IP能为终末期心脏病人提供可靠的血流动力学支持,过渡至心脏移植。
To study the effect of left ventricular assistant device (LVAD) , TCI Heart Mate 1000IP in rescue the terminal cardiac patients and its complications. Methods: The data for 9 cases of LVAD implantation were summarized. The primary heart diseases were: 4 cases of dilated cardiomyopathy. 4 coronary artery disease (CAD) and 1 congenital aortic stenosis combined with CAD. The ejection fraction (EF) before operation was 0. 145 ±0. 04. Results: After implantation of LVAD, cardiac output index (CI) increased from (1.76±0.50) Lm2min-1to (3.34±0.96) L-m2-min-J(P<0.05). Pulmonary arterial wedge pressure decreased from (28.6 ± 4.5) mmHg to (12.9 ±4. 9) mmHg (P<0.05). The mean 1CU stay were (17.3 ± 15.5) days. The mean support time for LVAD were (66.9 ±50.9) days. Among them 5 cases went over to heart transplantation and were discharged. Four patients died: 3 due to the right heart and respiratory failure and 1 due to the multiple organ failure. The main comlications were bleeding, right heart failure, neu-rocomplicaion and infection. Conclusions: TCI HeatrMate 1000IP could offer hemodynamic support for the terminal heart patients and let the patients go over to heart transplantation.
