Deutsches Herzzentrum Berlin, Department of Cardiovascular and Thoracic Surgery, Germany.
J Cardiovasc Transl Res. 2011 Jun;4(3):332-9. doi: 10.1007/s12265-011-9268-0. Epub 2011 Mar 11.
The implantation of ventricular assist devices (VADs) is a valuable option in patients with end-stage heart failure. The number of VAD implantations is growing worldwide. Between July 1987 and July 2010, we implanted 1,598 VADs in 1,455 patients. The majority were male (81.0%), and their mean age was 49.4 years (range 0.3-82 years). Indications for implantation were: cardiomyopathy (n = 1,074), post-cardiotomy heart failure (n = 282), acute myocardial infarction (n = 83), graft failure after heart transplantation (n = 64), and others (n = 61). In 55.5%, the VAD implanted was left ventricular, in 39.5% biventricular, and in 4.8% right ventricular. Until 1995, the implanted pumps were mostly pulsatile. Today, however, more than 95% of the implanted VADs are continuous-flow rotary pumps. The average support time was 148.6 days (range 0-1,836 days). The percentage of biventricular VADs has dropped over the years to 20% in 2009. Three hundred forty-seven patients could be successfully bridged to heart transplantation. In 122 patients (8.3%), the device could be explanted after myocardial recovery. In 2009, 31.4% of the patients were implanted for permanent support. During the study period, 521 patients could be discharged home or to a rehabilitation center. Implantation of ventricular assist devices is now an established treatment for patients with both acute and chronic end-stage heart failure. Small implantable left ventricular assist devices of the second and third generation are now broadly employed worldwide, with growing acceptance and decreasing complications. The percentage of biventricular support has dropped over the years to 20%.
心室辅助装置（VAD）的植入是晚期心力衰竭患者的一种有价值的选择。全球范围内 VAD 植入数量不断增加。在 1987 年 7 月至 2010 年 7 月期间，我们在 1455 名患者中植入了 1598 个 VAD。大多数患者为男性（81.0%），平均年龄为 49.4 岁（范围 0.3-82 岁）。植入的适应症包括：心肌病（n=1074）、心脏手术后心力衰竭（n=282）、急性心肌梗死（n=83）、心脏移植后移植物衰竭（n=64）和其他（n=61）。55.5%的患者植入了左心室 VAD，39.5%的患者植入了双心室 VAD，4.8%的患者植入了右心室 VAD。1995 年之前，植入的泵大多是搏动性的。然而，如今超过 95%的植入 VAD 是连续流动的旋转泵。平均支持时间为 148.6 天（范围 0-1836 天）。双心室 VAD 的比例逐年下降，2009 年降至 20%。347 例患者成功桥接心脏移植。122 例（8.3%）患者在心肌恢复后可取出设备。2009 年，31.4%的患者植入是为了进行永久性支持。在研究期间，521 例患者可出院回家或康复中心。心室辅助装置的植入现在是急性和慢性晚期心力衰竭患者的一种既定治疗方法。第二代和第三代小型植入式左心室辅助装置现已在全球范围内广泛应用，接受程度不断提高，并发症不断减少。双心室支持的比例逐年下降至 20%。
