La complicaci\u00f3 m\u00e9s greu que pot patir una persona poc despr\u00e9s de rebre un trasplantament de cor \u00e9s la fallada prim\u00e0ria de l\u2019empelt, responsable d\u2019un 30% de les morts en el primer mes posterior a la intervenci\u00f3. Per tractar aquesta fallada, el pacient ha de ser connectat a un assist\u00e8ncia mec\u00e0nica circulat\u00f2ria i respirat\u00f2ria, la membrana d\u2019oxigenaci\u00f3 extracorp\u00f2ria venoarterial (ECMO-VA), que substitueix de forma transit\u00f2ria les seves funcions card\u00edaca i pulmonar. Per aplicar l\u2019ECMO-VA s\u2019utilitzen unes c\u00e0nules de poliuret\u00e0 que permeten establir el circuit per a la circulaci\u00f3 de la sang i la seva oxigenaci\u00f3 extracorp\u00f2ria. El procediment de canulaci\u00f3 pot ser perif\u00e8ric, per l\u2019arteria i vena femoral, o central, per l\u2019aur\u00edcula dreta i aorta, segons l\u2019acc\u00e9s quir\u00fargic.<\/p>\n
<\/p>\n
Un estudi multic\u00e8ntric que ha liderat el grup Bioheart<\/a> de l\u2019Hospital Universitari de Bellvitge (HUB) i l\u2019IDIBELL constata que els pacients als qui s\u2019aplica la canulaci\u00f3 perif\u00e8rica en l\u2019ECMO-VA registren, als tres mesos de la intervenci\u00f3, una superviv\u00e8ncia superior en un 20% als que reben la canulaci\u00f3 central. El treball ha estat publicat a la revista The Journal of Heart and Lung Trasplantation<\/em><\/a>.<\/p>\n <\/p>\n L\u2019estudi s\u2019ha dut a terme a partir de l\u2019an\u00e0lisi retrospectiva de 2.376 trasplantaments card\u00edacs realitzats entre 2010 i 2020 en 14 hospitals de tot l\u2019Estat que hi han participat\u00a0 en el Registro Espa\u00f1ol del Trasplante Card\u00edaco. A m\u00e9s de les difer\u00e8ncies entre la canulaci\u00f3 central i la perif\u00e8rica, tamb\u00e9 s\u2019han analitzat els possibles beneficis del suport amb ECMO-VA preco\u00e7 (menys de 3 hores despr\u00e9s del trasplantament) enfront del m\u00e9s tard\u00e0 (m\u00e9s de 3 hores despr\u00e9s) en els casos de fallida prim\u00e0ria de l\u2019empelt, sense que s\u2019hagin trobat difer\u00e8ncies significatives.<\/p>\n <\/p>\n \u201cTot i que alguns treballs previs suggerien que la implantaci\u00f3 preco\u00e7 podia millorar el pron\u00f2stic dels pacients amb fallada prim\u00e0ria de l\u2019empelt, una de les principals conclusions del nostre estudi \u00e9s que no hi ha difer\u00e8ncies significatives entre l\u2019inici preco\u00e7 i el diferit, mentre que la canulaci\u00f3 perif\u00e8rica enfront la central si que mostra clars beneficis\u201d, segons explica el Dr. Jos\u00e9 Gonz\u00e1lez Costello, coordinador de la Unitat d\u2019Insufici\u00e8ncia Card\u00edaca del Servei de Cardiologia de l\u2019HUB, membre del grup Bio-Heart de l\u2019IDIBELL, i investigador principal d\u2019aquest estudi.<\/p>\n","protected":false},"excerpt":{"rendered":" El grup Bioheart ha fet una an\u00e0lisi retrospectiva de 2.376 trasplantaments card\u00edacs realitzats a 14 hospitals de tot l\u2019Estat i ha trobat que l\u2019elecci\u00f3 entre la canulaci\u00f3 perif\u00e8rica o central per a la col\u00b7locaci\u00f3 de l\u2019ECMO-Venoarterial determina una millora de la superviv\u00e8ncia.<\/p>\n","protected":false},"author":8,"featured_media":23869,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"default","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"default","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center 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