■CardioMEMS是一种经美国食品和药物管理局批准的用于血液动力学监测的可植入设备,适用于患有心力衰竭的成年患者。它已用于没有结构性心脏病和先天性心脏病的成年人群,但是我们没有儿科人群的数据。
■我们报告了儿童心脏MEMS植入的初始单中心经验。植入器械的可行性,程序性结果,并对儿科人群的临床效用进行了评估。
■在8名患有肺动脉高压(6/8,75%)和心力衰竭(2/8,25%)的儿科患者(平均年龄7岁,平均体重27.9kg)中植入了CardioMEMS设备,无技术并发症。7例(85%)患者通过股动脉途径输送装置,7例(85%)患者植入左肺动脉。无创记录肺动脉高压患者的肺动脉压可以监测平均肺动脉压的演变,加强血管扩张剂治疗,并避免控制心脏导管插入。心力衰竭患者,肺血流动力学监测指导心脏移植前减充血治疗。
■在儿科人群中植入CardioMEMS是一种可行的程序,可以对心力衰竭和肺动脉高压患者进行无创血流动力学监测。在选定的患者中实施有助于复杂心脏病患者的门诊随访和治疗管理,避免需要住院治疗的侵入性手术。建议在儿科人群中进行进一步的大规模研究。
UNASSIGNED: The CardioMEMS is an implantable device for hemodynamic monitoring approved by the US Food and Drug Administration for adult patients with heart failure. It has been used in the adult population without structural heart disease and with congenital heart diseases, but we do not have data in the pediatric population.
UNASSIGNED: We report the initial single-center experience of the CardioMEMS implantation in children. Feasibility of device implantation, procedural outcomes, and clinical utility in the pediatric population were evaluated.
UNASSIGNED: The CardioMEMS device was implanted without technical complications in 8 pediatric patients (mean age 7 years and mean weight 27.9 kg) with pulmonary hypertension (6/8, 75%) and heart failure (2/8, 25%). The device was delivered via femoral access in 7 (85%) patients and implanted in the left pulmonary artery in 7 (85%). The noninvasive recording of pulmonary pressures in patients with pulmonary hypertension allowed the monitoring of the evolution of mean pulmonary artery pressure, intensifying vasodilator treatment, and avoiding control cardiac catheterizations. In patients with heart failure, pulmonary hemodynamic monitoring guided the decongestive treatment prior to heart transplantation.
UNASSIGNED: The implantation of CardioMEMS in the pediatric population is a feasible procedure that allows the noninvasive hemodynamic monitoring of patients with heart failure and pulmonary hypertension. Its implementation in selected patients aids in outpatient follow-up and therapeutic management of patients with complex cardiac conditions, avoiding invasive procedures that require hospitalization. Further large-scale studies in the pediatric population are recommended.