Department of Cardiothoracic Transplantation & Mechanical Circulatory Support, Royal Brompton & Harefield NHS Foundation Trust, Harefield Hospital, Hill End Road, Harefield, Middlesex UB9 6JH, UK.
Expert Rev Med Devices. 2013 Jul;10(4):441-52. doi: 10.1586/17434440.2013.811851.
Increasing incidence of end-stage heart failure and limited availability of donor organs have led to longer waiting times for cardiac transplantation and subsequently increasing mortality. Ventricular assist device therapy is fast becoming an accepted alternative treatment to treat end-stage heart failure and is being implemented as a bridge to decision, bridge to myocardial recovery, bridge to heart transplantation or as a destination therapy. LVADs not only enable hemodynamic stabilization and recovery of secondary organ failure in severely ill patients, but have also been shown to reduce pulmonary vascular resistance in nontransplantable candidates. Technology of ventricular assist devices has evolved over several decades of time and generations of devices. The HVAD® Pump (HeartWare International, Inc., MA, USA) is a third-generation, miniaturized, continuous-flow ventricular assist device. Due to its miniaturized housing and intrapericardial placing, it can be used proficiently to support the right ventricle and has also demonstrated great utility in minimally invasive and off-pump implantation, exchange and explantation. It is favored for similar reasons in adolescents and in heart failure due to complex congenital heart disease. The purpose of this article is to review the clinical use of HeartWare® Ventricular Assist System (HeartWare System; HeartWare International, Inc.) with different strategies pertaining to its advantages and adverse events in comparison with contemporary devices.
不断增加的终末期心力衰竭发病率和有限的供体器官可用性导致心脏移植的等待时间延长，进而导致死亡率增加。心室辅助装置治疗正迅速成为治疗终末期心力衰竭的一种可接受的替代治疗方法，并被用作决策桥、心肌恢复桥、心脏移植桥或作为终末期治疗。LVAD 不仅能够使严重疾病患者的血液动力学稳定并恢复次要器官衰竭，而且还被证明可以降低非移植候选者的肺血管阻力。心室辅助装置的技术在过去几十年中经历了几代装置的发展。HVAD®泵（HeartWare International，Inc.，MA，USA）是第三代小型化连续流心室辅助装置。由于其小型化外壳和心包内放置，它可以熟练地用于支持右心室，并且在微创和非心脏跳动植入、交换和取出方面也显示出了巨大的效用。由于类似的原因，它在青少年和因复杂先天性心脏病而导致的心力衰竭中也受到青睐。本文的目的是回顾 HeartWare®心室辅助系统（HeartWare 系统；HeartWare International，Inc.）的临床应用，并比较其与当代装置相比的优势和不良事件的不同策略。
