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植入 HeartMate 3 患者的 5 年结果:单中心经验。

Five-year outcomes of patients supported with HeartMate 3: a single-centre experience.

机构信息

Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.

National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan.

出版信息

Eur J Cardiothorac Surg. 2021 Jun 14;59(6):1155-1163. doi: 10.1093/ejcts/ezab018.

Abstract

OBJECTIVES

The HeartMate 3 left ventricular assist device was first implanted in 2014 and received the Conformité Européenne mark in 2015. Since then, several trials demonstrated its high haemocompatibility associated with good survival and low adverse events rates. Herein, we report our institutional experience with patients supported with HeartMate 3 for 5 years.

METHODS

This prospective cohort study included patients receiving a HeartMate 3 implantation in 2014 as part of the HeartMate 3 Conformité Européenne Mark clinical trial. Patients had follow-up visits every 3 months while on left ventricular assist device support, and all patients completed the 5-year follow-up. The primary end point was survival at 5 years. Secondary end points included adverse events, health status and quality of life.

RESULTS

Eight patients (men: 75%) aged 59 years (min-max: 52-66 years) were enrolled. At 5 years, survival was 100%. Patients remained on support for a median time of 1825 days (min-max: 101-1825 days); 2 patients successfully received cardiac transplants. No right heart failure, haemolysis, pump thrombosis, pump malfunction or neurological events occurred in any patients. A driveline infection was observed in 6 patients (0.25 events/patient-year). Compared to baseline, a significant improvement in quality of life and in New York Heart Association functional class was noted after the implant and for the whole follow-up time. A slight decline in kidney function and in the 6-min walk test results occurred after 3 years.

CONCLUSIONS

This study reports the longest single-centre follow-up of the HeartMate 3, showing excellent haemocompatibility over time with high survival and low complication rates at 5 years.

摘要

目的

HeartMate 3 左心室辅助装置于 2014 年首次植入,并于 2015 年获得欧洲符合性标志。此后,多项试验证明其具有较高的血液相容性,同时具有良好的存活率和较低的不良事件发生率。在此,我们报告了我们机构在 5 年内使用 HeartMate 3 支持的患者的经验。

方法

这项前瞻性队列研究纳入了 2014 年接受 HeartMate 3 植入的患者,该患者是 HeartMate 3 欧洲符合性标志临床试验的一部分。患者在接受左心室辅助装置支持期间每 3 个月进行一次随访,所有患者均完成了 5 年的随访。主要终点是 5 年的生存率。次要终点包括不良事件、健康状况和生活质量。

结果

8 名患者(男性占 75%),年龄 59 岁(最小-最大:52-66 岁)。5 年时,生存率为 100%。患者中位支持时间为 1825 天(最小-最大:101-1825 天);2 名患者成功接受了心脏移植。没有发生任何患者的右心衰竭、溶血、泵血栓形成、泵故障或神经系统事件。6 名患者(0.25 例/患者-年)出现了导线感染。与基线相比,植入后和整个随访期间,生活质量和纽约心功能协会功能分级都有显著改善。3 年后,肾功能和 6 分钟步行试验结果略有下降。

结论

本研究报告了 HeartMate 3 的最长单中心随访,结果表明随着时间的推移具有良好的血液相容性,5 年时的生存率和并发症发生率都很高。

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