Boyle Andrew J
Division of Cardiology, Aurora St Luke's Medical Center, Milwaukee, Wisconsin 53215, USA.
J Card Surg. 2010 Jul;25(4):421-4. doi: 10.1111/j.1540-8191.2010.00997.x. Epub 2010 Feb 23.
A dramatic shift in the durability and reliability of ventricular assist device (VAD) therapy is taking hold due to the newer generations of continuous flow VADs that are either in clinical trials or under consideration by the Food and Drug Administration (FDA) for commercial approval. To expand the pool of potential mechanical circulatory support (MCS) patients, device reliability will need to prove to be greatly enhanced over previous generations of VADs and functional capacity and quality of life will need to improve substantially over baseline. Improved patient selection should have the simultaneously beneficial effects of improving outcomes while expanding the MCS patient population. The critical factors determining the likelihood of expansion of the MCS field include, but are not limited to, improvements in technology and its reliability, training and education of all advanced heart failure caregivers, improving availability of MCS geographically, and a shift in patient selection to a population more likely to benefit from MCS therapy.
由于新一代的连续血流心室辅助装置（VAD）正处于临床试验阶段或正在接受美国食品药品监督管理局（FDA）的商业批准审查，心室辅助装置（VAD）治疗的耐用性和可靠性正在发生巨大转变。为了扩大潜在的机械循环支持（MCS）患者群体，需要证明设备可靠性比前几代VAD有大幅提高，功能能力和生活质量也需要在基线水平上有显著改善。改进患者选择应同时具有改善治疗效果和扩大MCS患者群体的有益作用。决定MCS领域扩张可能性的关键因素包括但不限于技术及其可靠性的提高、所有晚期心力衰竭护理人员的培训和教育、在地理上提高MCS的可及性，以及将患者选择转向更有可能从MCS治疗中受益的人群。
