Early management after left ventricular assist device implantation in 22 patients: a single center experience
10.3760/cma.j.cn112434-20221212-00374
- VernacularTitle:22例左心室辅助装置植入患者术后早期管理的单中心经验
- Author:
Wei WANG
1
;
Yuan TANG
;
Shujie LI
;
Chao DU
;
Zhihao LI
;
Hao WANG
;
Xiaocheng LIU
Author Information
1. 泰达国际心血管病医院ICU，天津 300457
- Keywords:
Left ventricular assist device;
End-stage heart failure;
Anticoagulation;
Blood pressure;
Volume
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2023;39(9):535-539
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate and summarize the early management experience of 22 patients with end-stage heart failure(ESHF) who underwent left ventricular assist device(LVAD) implantation in an intensive care unit(ICU) in a single center.Methods:Data of 22 patients with ESHF treated with LVAD in the ICU of TEDA International Cardiovascular Hospital from September 2020 to August 2022 were retrospectively analyzed. There were 16 males and 6 females, aged from 20 to 67 years old, with a mean age of(51.0±13.3)years old. There were 21 cases with dilated cardiomyopathy, 1 case with ischemic cardiomyopathy, 6 cases with tricuspid regurgitation, 1 case with intra-aortic balloon pump for cardiogenic shock, and 5 cases with cardiac resynchronization therapy for arrhythmia. After the operation, all patients received restricted fluid therapy, a " stepwise" anticoagulation strategy, and strict blood pressure management. The postoperative complications and treatment process were reviewed, the treatment and management experience were summarized, and the prognosis of the patients was statistically analyzed.Results:All 22 patients survived within 90 days after surgery, and 21 patients(95.5%) recovered well, the pump works fine and there was no hemolysis and thrombosis of LVAD. Major complications included: 1 case of severe pneumonia(4.5%), 2 cases of pericardial tamponade(9.1%), 1 case of intracerebral hemorrhage(4.5%), 1 case of mediastinal infection(4.5%), 5 cases of positive occult blood in gastric juice(22.7%), no cases of right ventricular failure、aortic insufficiency and cerebral infarction. The duration of postoperative mechanical ventilation was 17(8.5, 51.5) h, and the ICU stay was 14(10, 27) days.Conclusion:LVAD is another effective treatment for patients with ESHF in addition to heart transplantation. Good postoperative blood pressure control, " stepwise" anticoagulation strategy and " restrictive" fluid management can reduce postoperative complications in the early phase of post-operation, which is crucial for the prognosis of patients with LVAD.
