Reedy J E, Ruzevich S A, Swartz M T, Termuhlen D F, Pennington D G
Prog Cardiovasc Nurs. 1989 Jan-Mar;4(1):1-9.
Four cardiac transplant candidates were supported with ventricular assist devices for periods ranging from 53 to 90 days (mean, 75 days). The patients were men who ranged in age from 36 to 49 years (mean, 44.5 years). Two patients had Pierce-Donachy biventricular assist devices (BVADs) and two patients had Novacor left ventricular assist systems (LVASs). Complications included infection (3 patients), development of antibodies (2 patients), bleeding (2 patients), and pump inflow obstruction (1 patient). All patients were maintained on an anticoagulation regimen which included warfarin and dipyridamole. They were extubated and ambulatory for most of the period of mechanical support. Thromboembolic complications did not develop in any of these patients, and they did not acquire infections which involved the mediastinum. They were successfully transplanted and discharged 11 to 25 days after transplantation. Although major complications were common in this small group of patients, all four patients achieved hemodynamic stability and became excellent candidates for cardiac transplantation. With proper patient selection and meticulous nursing care, current mechanical circulatory support technology is capable of maintaining patients consistently for periods of greater than 50 days.
四名心脏移植候选者接受了心室辅助装置支持，支持时间为53至90天（平均75天）。患者均为男性，年龄在36至49岁之间（平均44.5岁）。两名患者使用了Pierce-Donachy双心室辅助装置（BVAD），两名患者使用了Novacor左心室辅助系统（LVAS）。并发症包括感染（3例）、抗体产生（2例）、出血（2例）和泵流入道梗阻（1例）。所有患者均维持抗凝治疗方案，包括华法林和双嘧达莫。在机械支持的大部分时间里，他们都拔除了气管插管并可下床活动。这些患者均未发生血栓栓塞并发症，也未发生累及纵隔的感染。他们均成功接受了移植，并在移植后11至25天出院。尽管在这一小群患者中主要并发症很常见，但所有四名患者均实现了血流动力学稳定，成为心脏移植的优秀候选者。通过适当的患者选择和精心的护理，当前的机械循环支持技术能够持续维持患者超过50天。
