Higgins R S, Elefteriades J A
Department of Cardiothoracic Surgery, Yale University School of Medicine, New Haven, Connecticut.
Cardiol Clin. 1992 Feb;10(1):185-92.
Treatment of patients with severe right ventricular dysfunction follows a continuum of progressive therapies. If optimization of volume status and inotropic support do not adequately improve right ventricular function, higher levels of mechanical circulatory support are required. A right-sided intraaortic balloon pump has been helpful in such circumstances. The centrifugal pump and the artificial ventricle provide the most effective long-term circulatory support for patients with right ventricular or biventricular failure after cardiopulmonary bypass, myocardial infarctions, or as a bridge to cardiac transplantation. All of these support measures still carry a high morbidity and mortality. Survival in approximately one third of these high-risk patients can be expected with the use of right ventricular assist devices. Cardiopulmonary bypass has also been effective for circulatory support of patients with massive pulmonary emboli.
重度右心室功能障碍患者的治疗遵循一系列逐步递进的疗法。如果容量状态的优化和正性肌力支持不能充分改善右心室功能，就需要更高水平的机械循环支持。在这种情况下，右侧主动脉内球囊反搏泵会有所帮助。离心泵和人工心室为体外循环、心肌梗死后右心室或双心室衰竭的患者，或作为心脏移植的桥梁，提供了最有效的长期循环支持。所有这些支持措施仍然具有较高的发病率和死亡率。使用右心室辅助装置有望使大约三分之一的这类高危患者存活。体外循环对大面积肺栓塞患者的循环支持也很有效。
