Midterm follow-up of patients who underwent removal of a left ventricular assist device after cardiac recovery from end-stage dilated cardiomyopathy.
Midterm follow-up of patients who underwent removal of a left ventricular assist device after cardiac recovery from end-stage dilated cardiomyopathy.
复制标题
对终末期扩张型心肌病心脏恢复后接受移除左心室辅助装置的患者进行中期随访。
DOI：
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发表时间：
2000
影响因子：
6
通讯作者：
G. Wallukat
中科院分区：
文献类型：
--
作者：
R. Hetzer;Johannes Müller;Y. Weng;M. Loebe;G. Wallukat
客观的
最近，在使用左心室辅助装置进行临时支持后，终末期特发性扩张型心肌病的心脏恢复。我们报告了 4 年多前接受移除装置的患者的病史。
方法
自1994年6月以来，23名终末期特发性扩张型心肌病患者接受左心室辅助装置或双心室辅助装置支持1至26个月（平均6个月），超声心动图显示心脏完全或广泛恢复后，接受了装置的移除。
结果
7 名患者（A 组）在 4 至 24 个月后出现复发性心力衰竭。 6 名患者接受了移植手术，其中 1 名患者在等待期间死亡。三名患者在移除辅助装置后 4 个月零 3 天内死于非心脏原因。 13 名患者（B 组）心脏恢复稳定，持续时间为 3 至 49 个月（平均 23 个月）。植入时，各组之间在年龄、血流动力学、左心室射血分数、舒张期左心室内径和自身抗体水平方面没有显着差异。 2个月后射血分数的增加和左心室舒张期内径的减小均极显着。与 B 组相比，A 组患者的心力衰竭病史、首发心脏症状和辅助持续时间更长。B 组在辅助装置上表现出更快的心脏恢复速度，因此支持时间更短。此外，B 组在辅助装置拔除时的恢复程度更完全。装置放置时的年龄是辅助装置持续时间的唯一影响因素。心力衰竭复发的概率受心力衰竭持续时间的影响。
结论
对于特定的特发性扩张型心肌病患者，使用左心室辅助装置减负荷后可以实现持久恢复。持久的心脏恢复似乎与功能正常化和卸载期间更快的恢复有关。
OBJECTIVE
Cardiac recovery in end-stage idiopathic dilated cardiomyopathy recently occurred after temporary support with a left ventricular assist device. We report the case histories of patients who underwent removal of the device more than 4 years ago.
METHODS
Since June 1994, 23 patients with end-stage idiopathic dilated cardiomyopathy who were supported by a left ventricular assist device or biventricular assist device for 1 to 26 months (mean, 6 months) underwent removal of the device after complete or extensive cardiac recovery, as revealed by echocardiography.
RESULTS
Seven patients (group A) had recurrent cardiac failure after 4 to 24 months. Transplantation was performed in 6 patients, and one died while on the waiting list. Three patients died of noncardiac causes within a period of 4 months and 3 days after removal of the assist device. Stable cardiac recovery occurred in 13 patients (group B) for 3 to 49 months (mean, 23 months). At the time of implantation, there were no significant differences between the groups with regard to age, hemodynamics, left ventricular ejection fraction, left ventricular internal diameter in diastole, and autoantibody levels. The increase of ejection fraction and the decrease of left ventricular internal diameter in diastole after 2 months were highly significant. The patients in group A had longer histories of heart failure and first cardiac symptoms and duration of assist when compared with group B. Group B demonstrated a quicker cardiac recovery on the assist device, and thus support was shorter. Also, the degree of recovery at assist device explantation was more complete in group B. The age at the time of device placement was the only influencing factor for duration on the assist device. The probability of recurrence of heart failure was influenced by the duration of heart failure.
CONCLUSIONS
In selected patients with idiopathic dilated cardiomyopathy, lasting recovery can be achieved after unloading with a left ventricular assist device. Lasting cardiac recovery seems to be related to functional normalization and a more rapid recovery during the unloading period.
影响因子：
37.8
作者：
Mancini, DM;Beniaminovitz, A;Oz, M
通讯作者：
Oz, M