Tranzitorni signali visokog intenziteta u bolesnika s ugrađenim cirkulacijskim crpkama

master's thesis

• Title (english): High intensity transient signals in patients with ventricular assist devices
• Author: Vivien Mitrović
• Mentor: Bojan Biočina (mentor)
• Committee member: Hrvoje Gašparović (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Bojan Biočina (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Zatajenje srca sindrom je multifaktorske etiologije od kojeg boluje 1-2% odrasle populacije. Odsutnost odgovarajućeg broja donora za transplantaciju srca doprinjela je uporabi cirkulacijskih crpki, koje sa sobom nose rizik od komplikacija kao što je tromboza crpke. Transkranijalni Doppler ultrazvuk omogućuje nam detektiranje tranzitornih signala visokog intenziteta u bolesnika s ugrađenim LVAD-om za koje se smatra da predstavljaju mikroemboluse koji potječu iz cirkulacijske crpke.
U ovom radu ukupno je sudjelovalo deset ispitanika s tri različite vrste LVAD-a. Broj tranzitornih signala visokog intenziteta detektiran je pomoću transkranijalnog Doppler uređaja frekvencije 2MHz u srednjoj cerebralnoj arteriji tijekom vremena od 60 minuta, putem transtemporalnog koštanog prozora.
Cilj ovog rada bio je utvrditi broj tranzitornih signala visokog intenziteta u bolesnika s ugrađenim cirkulacijskim crpkama, te ustanoviti razlikuje li se taj broj u pacijenata s različitom vrstom ugrađene cirkulacijske crpke.
U ispitanika ove studije ukupno je zabilježeno 36 HITS-a, prosječno 3,6 po ispitaniku. Najveći prosjek zabilježenih HITS-a imala je HeartMate 3 u iznosu od 4,71 po ispitaniku, dok su HeartMate 2 i HeartWare HVAD imale zabilježen prosječno 1 HITS po ispitaniku. Najveći broj ispitanika (70%) imalo je HeartMate 3 cirkulacijsku crpku.
Potrebna su daljnja istraživanja koja bi mogla ukazati na razliku u količini zabilježenih HITS-a u odnosu na vrstu ugrađene LVAD-a. Metoda snimanja tranzitornih signala visokog intenziteta pomoću transkranijalnog Doppler uređaja u ovom se istraživanju pokazala brzom i sigurnom metodom kojom u realnom vremenu i uz krevet bolesnika možemo dobiti podatak o broju HITS-a koji bi mogli imati prediktivnu vrijednost za trombozu crpke i klinički značajan tromboembolizam.

Abstract (english)

Heart failure is a syndrome of multifactorial etiology from which suffers 1-2% of the adult population. The absence of adequate number of heart donors contributes to the use of ventricular assist devices, which carry the risk of complications such as pump thrombosis. Transcranial Doppler ultrasound enables detection of the high intensity transient signals in patients with LVAD. These HITSs are considered to represent the microemboli that originate from the ventricular assist device.
This study enrolled ten patients with three different types of left ventricular assist devices. The number of HITSs was detected by transcranial Doppler ultrasound with a frequency of 2 MHz in the middle cerebral artery over a period of 60 minutes, through a transtemporal bone window.
The aim of this study was to determine the number of HITSs in patients with left ventricular assist device and whether this number differs in patients with a different type of LVAD. A total of 36 high intensity transient signals was recorded, averaging 3,6 per patient. The highest average of recorded HITSs had a HeartMate 3 ventricular assist device with a total of 4,71 per patient, whereas the HeartMate 2 and HeartWare HVAD had an average of 1 HITS. 70% of the patients had a HeartMate 3 left ventricular assist device.
Further research that could point to the significance in the amount of the detected HITSs in relation to the type of VADs is required. The detection of HITSs using the transcranial Doppler ultrasound showed as a fast and secure real-time bedside method of obtaining information on the number of HITSs that could have a predictive value for pump thrombosis and clinically significant thromboembolism.

• Keywords: cirkulacijske crpke; HITS; LVAD; srednja cerebralna arterija; tranzitorni signali visokog intenziteta; transkranijalni Doppler ultrazvuk
• Keywords (english): high intensity transient signals; HITS; LVAD; middle cerebral artery; transcranial Doppler ultrasound; ventricular assist devices
• Language: croatian
• URN:NBN: urn:nbn:hr:105:529631
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2020-03-09 08:58:28