Mazurenko, O. P. Experience of personalized treatment of pediatric patients with implanted left ventricular assist devices in the postoperative period = Досвід персоналізації лікування в педіатричних пацієнтів з імплантованими пристроями механічної підтримки лівого шлуночка в ранньому післяопераційному періоді / O. P. Mazurenko // Медицина невідкладних станів = Медицина неотложных состояний. - 2019. - N 6. - P137-141. - Бібліогр. наприкінці ст. MeSH-головна: СЕРДЕЧНАЯ НЕДОСТАТОЧНОСТЬ -- HEART FAILURE (терапия, хирургия) ПОСЛЕОПЕРАЦИОННОЕ ВЕДЕНИЕ БОЛЬНОГО -- POSTOPERATIVE CARE СЕРДЦЕ, АППАРАТЫ ДЛЯ ПОДДЕРЖКИ ДЕЯТЕЛЬНОСТИ -- HEART-ASSIST DEVICES ДЕТИ -- CHILD Анотація: In adult patients, continuous-flow mechanical circulatory support devices completely prevail over pulsatile ones, representing more than 90 %. With the constant miniaturization of devices, the number of proposals of pediatric cardiologists regarding the use of continuous-flow ventricular assist devices (VAD) in children is growing. According to the first PediMACS report, approximately half (54 %; 109 of 200) of registered long-term devices are continuous-flow devices. This article describes the current state of the children’s continuous-flow system for mechanical circulatory support and evaluates the prospects for its future use. The strategy of the Silesian Center for Heart Diseases in the early postoperative period was very similar to that used in patients after Fontan procedure, including special tactics of respiratory support, adding nitric oxide or leaving the chest open after the start of circulation support. Despite aggressive management, a certain part of the patients had right ventricular failure, which required temporary mechanical support to restore blood flow in the pulmonary circulation and increase left ventricular preload. Early biventricular support correlates with better survival compared to its delayed use. Thus, a thorough preoperative risk assessment of right ventricular failure is required for implantation of biventricular assist device or for heart transplantation Вільних прим. немає |