中国临床医学2025，Vol.32Issue(1)：72-77,6.DOI:10.12025/j.issn.1008-6358.2025.20240938
心室辅助装置植入后左心瓣膜反流的随访研究
Follow-up study of left heart valve regurgitation after implantation of left ventricular assist device
摘要
Abstract
Objective To explore the valve regurgitation status of left heart after the implantation of left ventricular assist device(LVAD)and its effect on prognosis of patients with LVAD implantation.Methods A total of 35 patients with cardiomyopathy who underwent magnetic levitation LVAD implantation at Zhongshan Hospital,Fudan University from February 2021 to July 2024 were retrospectively selected.Clinical data during hospitalization were collected,including preoperative basic data and postoperative valve regurgitation status.Telephone follow-ups were conducted to monitor patients'survival status and transthoracic echocardiography was used to assess left valve function.Kaplan-Meier survival curves and log-rank test were employed to compare the survival rate of patients with different levels of valve regurgitation.Results The 35 patients had a mean age of(53.9±11.1)years,with 85.7%male,and 3 patients(8.6%)died during hospitalization.Preoperatively,17 patients(48.6%)had moderate or greater mitral regurgitation,while all 35 patients had less than moderate aortic regurgitation.One month postoperatively,thirty patients were followed up,among which 24 patients(80%)had less than moderate mitral regurgitation,including 11 cases with alleviated regurgitation compared to pre-surgery;6 patients(20%)had moderate or greater mitral regurgitation,including 4 cases with stable regurgitation and 2 cases with progression of regurgitation compared to pre-surgery;2 patients(6.7%)had progression of aortic regurgitation to moderate or greater.The follow-up time was 1.2(1.0,2.1)years,with 1-year survival rate of 91.4%and 3-year survival rate of 71.1%.Survival analysis showed that the 3-year survival rate of patients with moderate or greater mitral regurgitation one month postoperatively was significantly lower than that of patients with less than moderate regurgitation(66.7%vs 83.3%,P=0.046).Conclusions After the implantation of magnetic levitation LVAD,most patients showed improvement in mitral regurgitation,while aortic regurgitation remained unchanged.The degree of mitral regurgitation one month postoperatively is associated with prognosis.关键词
左心室辅助装置/心力衰竭/左心瓣膜反流/预后Key words
left ventricular assist device/heart failure/left heart valve regurgitation/prognosis分类
医药卫生引用本文复制引用
刘峻江,马文锐,刘鼎乾,赵赟,董丽莉,罗哲,郭克芳,王春生,孙晓宁..心室辅助装置植入后左心瓣膜反流的随访研究[J].中国临床医学,2025,32(1):72-77,6.基金项目
上海市市级医院新兴前沿联合攻关项目(SHDC12024146),上海市启明星项目扬帆专项(23YF1405800).Supported by Shanghai Municipal Hospital Emerging Frontiers Joint Research Project(SHDC12024146)and Shanghai Youth Yangfan Project(23YF1405800). （SHDC12024146）
