Interventional Procedures for Left Ventricular Assist Device-Associated Complications

被引:9
作者
Lanmueller, Pia [1 ,2 ]
Eulert-Grehn, Jaime-Juergen [1 ,2 ]
Unbehaun, Axel [1 ,2 ]
Klein, Christoph [3 ]
Hommel, Matthias [4 ]
Kofler, Markus [1 ,2 ]
Kempfert, Joerg [1 ,2 ]
Hoermandinger, Christoph [1 ]
Kaufmann, Friedrich [1 ]
Stawowy, Philipp [2 ,3 ]
Dreysse, Stephan [3 ]
Mulzer, Johanna [1 ]
Mueller, Marcus [1 ]
Falk, Volkmar [1 ,2 ,5 ,6 ,7 ,8 ,9 ]
Schoenrath, Felix [1 ,2 ]
Potapov, Evgenij [1 ,2 ]
Just, Isabell A. [1 ,2 ]
机构
[1] German Heart Ctr Berlin, Dept Cardiothorac & Vasc Surg, Berlin, Germany
[2] DZHK German Ctr Cardiovasc Res, Partner Site Berlin, Berlin, Germany
[3] German Heart Ctr Berlin, Dept Internal Med Cardiol, Berlin, Germany
[4] German Heart Ctr Berlin, Dept Cardiac Anesthesiol & Intens Care Med, Berlin, Germany
[5] Charite Univ Med Berlin, Berlin, Germany
[6] Free Univ Berlin, Berlin, Germany
[7] Humboldt Univ, Berlin, Germany
[8] Berlin Inst Hlth, Berlin, Germany
[9] Swiss Fed Inst Technol, Dept Hlth Sci & Technol, Zurich, Switzerland
关键词
intervention; transcatheter aortic valve replacement; stent; left ventricular assist device; AORTIC-VALVE-REPLACEMENT; TRANSCATHETER; INSUFFICIENCY; OBSTRUCTION; DIAGNOSIS; IMPLANTATION; PREDICTORS; OUTCOMES; PATIENT;
D O I
10.1097/MAT.0000000000001674
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
As patients on long-term left ventricular assist device (LVAD) face a substantial risk for open cardiac reoperation, interventional treatment approaches are becoming increasingly important in this population. We evaluated data of 871 patients who were on LVAD support between January 1, 2016 and December 1, 2020. Interventional treatments for LVAD-associated complications were performed in 76 patients. Seventeen patients underwent transcatheter aortic valve replacements (TAVR) and 61 patients underwent outflow graft interventions (OGI). TAVR improved symptoms in patients with severe symptomatic aortic regurgitation. Postinterventional complications included aggravation of preexisting right heart failure (RHF), third-degree atrioventricular block, and intrapump thrombosis (in 3 [16.7%], 2 [11.1%], and 1 [5.6%] patients, respectively). In outflow graft obstructions, OGI led to recovery of LVAD flow (p < 0.001), unloading of the left ventricle (p = 0.004), decrease of aortic valve opening time (p = 0.010), and improvement of right heart function (p < 0.001). Complications included bleeding, RHF, and others (in 9 [10.8%], 5 [6.0%], and 5 [6.0%] patients, respectively). Eight (9.6%) patients died within the hospital stay after OGI, including mortality secondary to prolonged cardiogenic shock. In conclusion, interventional procedures are a feasible and safe treatment modality for LVAD-associated complications.
引用
收藏
页码:1332 / 1338
页数:7
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