Stone Marc E
Mount Sinai School of Medicine, New York, New York 10029-6574, USA.
Semin Cardiothorac Vasc Anesth. 2007 Sep;11(3):185-204. doi: 10.1177/1089253207306093.
Mechanical circulatory support has become an increasingly used management strategy for patients with both acute and chronic ventricular failure. This article briefly reviews the current state of mechanical circulatory support with a focus on indications, contraindications, and complications of currently available devices. Perioperative considerations for ventricular assist device implantation are discussed, including the decision-making process underlying the use of univentricular versus biventricular support, specific anesthetic considerations, and the role of transesophageal echocardiography where ventricular assist devices are concerned. The anesthetic considerations for the patient already supported by a ventricular assist device presenting for noncardiac surgery are also reviewed. The work concludes with a discussion of the rationale behind the next generation of continuous flow devices currently in human clinical trials.
机械循环支持已成为治疗急慢性心室衰竭患者越来越常用的管理策略。本文简要回顾了机械循环支持的现状，重点关注现有设备的适应证、禁忌证和并发症。讨论了心室辅助装置植入的围手术期注意事项，包括使用单心室支持与双心室支持的决策过程、具体的麻醉注意事项以及经食管超声心动图在心室辅助装置方面的作用。还回顾了已接受心室辅助装置支持的患者进行非心脏手术时的麻醉注意事项。本文最后讨论了目前正在进行人体临床试验的下一代连续流装置背后的原理。
