Daneshmand Mani A, Milano Carmelo A
Department of General and Thoracic Surgery, Duke University Medical Center, DUMC 3043, Durham, NC 27710, USA.
Surg Clin North Am. 2009 Aug;89(4):967-99, x. doi: 10.1016/j.suc.2009.06.007.
Patients with heart failure represent a significantly ill cohort, and the survival of the most advanced heart failure patients is dismal with medical management alone. This cohort of advanced heart-failure patients benefits from several surgical treatments. Although several techniques for surgical ventricular restoration in the setting of left ventricular aneurysms have been described, the broader application of these techniques to patients with ischemic cardiomyopathy has occurred during the last decade. This review focuses on left ventricular aneurysm (LVA) repair and surgical ventricular restoration, ventricular assist devices, and cardiac allograft transplantation for the treatment of advanced heart failure. Indications for these procedures are addressed, as well as intraoperative technical features and postoperative management strategies.
心力衰竭患者是一个病情严重的群体，仅靠药物治疗，最晚期心力衰竭患者的生存率很低。这一晚期心力衰竭患者群体受益于多种外科治疗方法。虽然已经描述了几种针对左心室室壁瘤进行外科心室修复的技术，但在过去十年中，这些技术在缺血性心肌病患者中的应用更为广泛。本综述重点关注左心室室壁瘤（LVA）修复和外科心室修复、心室辅助装置以及心脏同种异体移植治疗晚期心力衰竭。文中阐述了这些手术的适应症、术中技术特点以及术后管理策略。
