Preoperative Prediction of Aortic Insufficiency During Ventricular Assist Device Treatment.
Preoperative Prediction of Aortic Insufficiency During Ventricular Assist Device Treatment.
复制标题
心室辅助装置治疗期间主动脉瓣关闭不全的术前预测。
DOI：
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发表时间：
2016
影响因子：
1.5
通讯作者：
K. Kinugawa
中科院分区：
文献类型：
--
作者：
T. Imamura;K. Kinugawa
由于连续流左心室辅助装置（LVAD）的发展，D期心力衰竭患者的生存率显著提高，但主动脉瓣关闭不全（AI）仍然是影响患者生活质量的主要未解决并发症之一。目前还没有确定的AI治疗方法，需要术前预测和预防AI。自体主动脉瓣（AV）的开放是预防AI的充分条件，而由于LV逆向重构（LVRR）而导致的LV射血分数的改善对于开放自体AV至关重要。术前β受体阻滞剂治疗不足和脉动流LVAD的使用是LVRR、AV开放和预防AI的关键。导致AI的第二种机制是主动脉根的重塑和自体AV的变性，这是由LVAD支持期间的脉压降低引起的。与轴流泵相比，离心或脉动流LVAD的使用在保持脉动性方面具有优势，并且可以防止AI。充分的β受体阻滞剂治疗避免AI的可能性较小，这些患者可能是LVAD植入时对自体AV进行伴随手术干预的良好候选人。
Survival rate in patients with stage D heart failure has improved significantly owing to the development of continuous flow left ventricular assist devices (LVAD), but aortic insufficiency (AI) still remains one of the major unsolved complications that impairs patient quality of life. There are no established treatments for AI, and preoperative prediction and prevention of AI is needed. The opening of a native aortic valve (AV) is a sufficient condition for prevention of AI, and improvement of LV ejection fraction due to LV reverse remodeling (LVRR) is essential to open a native AV. Preoperative insufficient β-blocker treatment and pulsatile flow LVAD usage are keys for LVRR, opening of an AV, and prevention of AI. The second mechanism that leads to AI is remodeling of the aortic root and degeneration of a native AV, which results from reduced pulse pressure during LVAD support. Centrifugal or pulsatile flow LVAD usage has an advantage in terms of preserving pulsatility, and may prevent AI compared with an axial pump. There is less probability of avoiding AI with sufficient β-blocker treatment, and these patients may be good candidates for concomitant surgical intervention to a native AV at the time of LVAD implantation.
影响因子：
6
作者：
Simon, Marc A.;Primack, Brian A.;Teuteberg, Jeffrey;Kormos, Robert L.;Bermudez, Christian;Toyoda, Yoshiya;Shah, Hemal;Gorcsan, John, III;McNamara, Dennis M.
通讯作者：
McNamara, Dennis M.
影响因子：
4.6
作者：
Aggarwal, Ashim;Raghuvir, Rashmi;Bhat, Geetha
通讯作者：
Bhat, Geetha
DOI：
10.1115/1.4023525
发表时间：
2013-03
期刊：
Journal of biomechanical engineering
影响因子：
--
作者：
J. R. Stanfield;C. Selzman
通讯作者：
J. R. Stanfield;C. Selzman