Sawa Yoshiki
Department of Cardiovascular Surgery, Osaka University, Osaka, Japan.
Nihon Geka Gakkai Zasshi. 2006 Jan;107(1):27-32.
Heart transplantation had been an only effective treatment for severe congestive heart failure secondary to dilated or ischemic cardiomyopathy. Recently, mitral valve repair and left ventricular reconstruction have been introduced to restore their own cardiac function. These operations can be one of treatment options for relatively stable congestive heart failure patients. For those with severer heart failure complicated with cardiogenic shock or end-organ dysfunction, use of mechanical assist device should be included in the treatment strategies. Perioperative problems of implantation of left ventricular assist device include right heart failure, multi-organ failure, infection and anti-coagulation. Implantable LVAS, which provides potent circulatory assist is useful to overcome organ dysfunction and render good QOL during long waiting period for heart transplantation.
心脏移植一直是治疗由扩张型或缺血性心肌病引起的严重充血性心力衰竭的唯一有效方法。最近，二尖瓣修复和左心室重建已被引入以恢复自身心脏功能。这些手术可以作为相对稳定的充血性心力衰竭患者的治疗选择之一。对于那些患有更严重心力衰竭并伴有心源性休克或终末器官功能障碍的患者，治疗策略应包括使用机械辅助装置。左心室辅助装置植入的围手术期问题包括右心衰竭、多器官衰竭、感染和抗凝。可植入式左心室辅助系统能提供强大的循环辅助，有助于克服器官功能障碍，并在心脏移植的漫长等待期内使患者有良好的生活质量。
