Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, MD 21287, USA.
Curr Opin Anaesthesiol. 2010 Feb;23(1):57-66. doi: 10.1097/ACO.0b013e3283346c83.
Over the past two decades, medicine has seen a robust increase in the use of ventricular assist devices. The purpose of this review is to update the information concerning these devices, their advantages and disadvantages as well as their complications. This is essential, as the demand for these devices is increasing due to the increasing number of patients with end-stage heart failure and limited number of donor hearts available for transplantation.
First-generation devices consisted of large, cumbersome consoles requiring patient immobilization and often times hospitalization in an ICU setting. Second-generation models focused on patient mobility and discharge from hospital with an improvement in infection rates as well as 1 and 2-year survival rates. Designs for newer devices are focusing on full implantation without percutaneous lines, axial flow mechanisms and patient comfort. Additionally, total artificial hearts are being designed for the treatment of biventricular failure. The indications for ventricular assist devices are also being expanded to include destination therapy and alternatives to cardiac transplantation, as the supply of organs continues to be limiting.
This paper reviews the characteristics, outcomes and design of ventricular assist devices.
在过去的二十年中，心室辅助装置在医学领域得到了广泛应用。本文旨在更新这些装置的相关信息，包括它们的优缺点和并发症。这是必要的，因为随着终末期心力衰竭患者数量的增加以及可用于移植的供心数量有限，对这些设备的需求也在不断增加。
第一代设备由大型、笨重的控制台组成，需要患者保持固定姿势，并且经常需要在 ICU 住院。第二代模型侧重于患者的移动性和出院，从而提高了感染率以及 1 年和 2 年的生存率。新型设备的设计侧重于无需经皮线路、轴向流动机制和患者舒适度的完全植入。此外，正在设计全人工心脏以治疗双心室衰竭。心室辅助装置的适应证也在扩大，包括终末期治疗和心脏移植的替代方案，因为器官供应仍然有限。
本文综述了心室辅助装置的特点、结果和设计。
