Perioperative management strategy and efficacy of the left ventricular assist device HeartCon in the treatment of adult patients with end-stage heart failure
10.3760/cma.j.cn112434-20231102-00109
- VernacularTitle:HeartCon型左心室辅助装置治疗成人终末期心衰的围手术期处理策略与疗效观察
- Author:
Wei ZHANG
1
;
Yongfeng SHAO
;
Buqing NI
;
Linfei ZHANG
;
Yuanyuan SONG
;
Sheng ZHAO
;
Haoliang SUN
Author Information
1. 江苏省人民医院心脏大血管外科，南京 210029
- Keywords:
Left ventricular assist device;
Heart failure;
Perioperative management;
Follow-up;
Clinical efficacy
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2024;40(5):262-268
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To discuss the perioperative management strategy of the HeartCon left ventricular assist device in the treatment of adult patients with end-stage heart failure and evaluate the effectiveness of blood pump.Methods:Ten consecutive patients with end-stage heart failure treated with the LVAD HeartCon at the Department of Cardiovascular Surgery, Jiangsu Province Hospital from July 2021 to July 2023 were enrolled in this study. The clinical data and follow-up results were retrospectively analyzed. Blood pump parameter, cardiac function classification, liver and kidney function, coagulation, myocardial markers, N-terminal pro-B-type natriuretic peptide, von Willebrand factor antigen, echocardiography, cardiothoracic ratio, and 6-minute walking distance test (6MWT) were evaluated before and after implantation of LVAD in 30, 60, 90, 180, 360, 540, and 720 days. EQ-5D-5L questionnaire was used to evaluate the quality of life.Results:There were 9 males and 1 female with a mean age of (53.7±9.7) years. All patients survived. Renal insufficiency occurred in 1 patient and recurrent aseptic granuloma occurred in 1 patient. There were no significant differences in aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), serum creatinine (Scr), blood urea nitrogen (BUN), right ventricular fractional area change (FAC) and tricuspid annular plane systolic excursion (TAPSE) between pre-operation and 30, 60 and 90 days post-operation( P>0.05). The levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP), von Willbrand factor (vWF) antigen, left ventricular end-diastolic diameter (LVDd) and cardiothoracic ratio decreased significantly on the 30th, 60th and 90th day after operation ( P<0.05). The left ventricular ejection fraction (LVEF), 6MWT and EQ-5D-5L scores were significantly increased at 30, 60 and 90 days after operation compared with those before operation ( P<0.05). Conclusion:With the left ventricular assist device HeartCon, the cardiac function and quality of life of patients were significantly improved within 3 months after operation, and no serious complications were observed, proving that the device is safe and effective.
