Journal of cardiothoracic and vascular anesthesia · 2019
Periprocedural Dynamics of Aortic Regurgitation in Patients Supported With an Impella Left Ventricular Assist Device.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Butala Brian, Yu Raymond, Schorr Rebecca, Gologorsky Edward
Аннотация
OBJECTIVES: To determine the presence of and periprocedural changes caused by aortic regurgitation (AR) in patients supported with an Impella (Abiomed, Danvers, MA) left ventricular assist device.
DESIGN: Retrospective.
SETTING: Tertiary academic medical center.
PARTICIPANTS: Patients who underwent insertion of an Impella device at Allegheny General Hospital from January 2015 to December 2018.
INTERVENTIONS: Analysis of patient electronic medical records.
MEASUREMENTS AND MAIN RESULTS: Demographic information; comorbidities; duration of support; and the presence and severity of AR pre-procedure and post-procedure, as reported by echocardiography, were analyzed. The electronic medical records of 69 patients were included in the present study. Before placement of the Impella device, 25 (35%) patients showed detectable AR, with 18 (26%) showing mild AR and 7 (10%) showing moderate AR. After the removal of the Impella device, AR remained steady or increased in 61 patients. Fifteen patients (22%) demonstrated mild AR, 6 (8.7%) demonstrated moderate AR, and 2 (2.9%) demonstrated severe AR. An increase in severity of AR was noted in 9 patients (14.7%), and 52 patients (85%) had no change in the severity of AR. The duration of support with the Impella device, demographic variables, and comorbidities were not associated with a statistically significant risk for increased severity of post-procedural AR in multiple multivariable logistic regression analyses.
CONCLUSIONS: The presented data suggest that after Impella device support, a significant proportion of patients may show evidence of increased AR. Additional studies are needed to understand the etiology and significance of this observation.
DESIGN: Retrospective.
SETTING: Tertiary academic medical center.
PARTICIPANTS: Patients who underwent insertion of an Impella device at Allegheny General Hospital from January 2015 to December 2018.
INTERVENTIONS: Analysis of patient electronic medical records.
MEASUREMENTS AND MAIN RESULTS: Demographic information; comorbidities; duration of support; and the presence and severity of AR pre-procedure and post-procedure, as reported by echocardiography, were analyzed. The electronic medical records of 69 patients were included in the present study. Before placement of the Impella device, 25 (35%) patients showed detectable AR, with 18 (26%) showing mild AR and 7 (10%) showing moderate AR. After the removal of the Impella device, AR remained steady or increased in 61 patients. Fifteen patients (22%) demonstrated mild AR, 6 (8.7%) demonstrated moderate AR, and 2 (2.9%) demonstrated severe AR. An increase in severity of AR was noted in 9 patients (14.7%), and 52 patients (85%) had no change in the severity of AR. The duration of support with the Impella device, demographic variables, and comorbidities were not associated with a statistically significant risk for increased severity of post-procedural AR in multiple multivariable logistic regression analyses.
CONCLUSIONS: The presented data suggest that after Impella device support, a significant proportion of patients may show evidence of increased AR. Additional studies are needed to understand the etiology and significance of this observation.