RESUMO
Cardiac tamponade after ventricular assist device or total artificial heart implantation can typically occur within days or weeks after surgery. This report describes the case of a woman who presented over 4 years after SynCardia 70cc total artificial heart implantation, with physiology consistent with right ventricular outflow tract obstruction. The cause was initially attributed to device membrane failure based on the device console waveform; however, during operative exploration, a large amount of proteinaceous exudate was surrounding the device and causing the obstruction. This report illustrates how tamponade can result years after device implantation, secondary to porosity of the outflow grafts.
Assuntos
Tamponamento Cardíaco/etiologia , Insuficiência Cardíaca/cirurgia , Coração Artificial/efeitos adversos , Complicações Pós-Operatórias , Implantação de Prótese/efeitos adversos , Tamponamento Cardíaco/diagnóstico , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Fatores de Tempo , Tomografia Computadorizada por Raios XRESUMO
Extracorporeal membrane oxygenation (ECMO) support is a life-saving but complex technique for patients suffering from severe cardiac or pulmonary dysfunction. Increasingly greater utilization in the last 15 years means that a suite of mortality risk analytics is both feasible for researchers and required by clinicians, patients, administrators, and insurers. We argue that to date, research into such risk analytics has been insufficient and does not adequately reflect the various indications and configurations of extracorporeal life support (ECLS). We propose a path to address these challenges and ensure that clinicians and researchers obtain robust, specific, risk analytics.