长期左心室辅助装置植入的微创及替代方法：范德比尔特策略
Minimally invasive and alternative approaches for long-term LVAD placement: the Vanderbilt strategy.
作者信息
Maltais Simon, Davis Mary E, Haglund Nicholas
机构信息
1 Department of Cardiothoracic Surgery, 2 Division of Cardiovascular Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN 37232-8808, USA.
出版信息
Ann Cardiothorac Surg. 2014 Nov;3(6):563-9. doi: 10.3978/j.issn.2225-319X.2014.10.02.
BACKGROUND
Minimally invasive and alternative strategies for implantation have been anecdotally reported for contemporary continuous-flow left ventricular assist device (CF-LVAD) placement.
METHODS
We reviewed our experience at a single center with alternative strategies for implantation of the HeartMate II and HeartWare CF-LVADs, in patients with advanced heart failure (HF). This featured article focuses on the associated surgical techniques and patient management pitfalls.
RESULTS
For appropriately selected cases, our group believes that these alternative strategies allow for the development of novel and less traumatic surgical approaches for CF-LVAD implantation. With reproducible outcomes, these approaches also promise the possibility of increasing the number of high-risk surgical patients who could benefit from CF-LVAD therapies.
CONCLUSIONS
This work has detailed a variety of less invasive alternative strategies for implantation of long-term LVADs. These newer approaches have the potential for significant advancements in the field of cardiothoracic surgery. Large-scale collaborative studies will be needed to clarify the potential advantages and disadvantages of these novel techniques on patient outcomes.
背景
对于当代连续流左心室辅助装置（CF-LVAD）植入，已有关于微创及替代植入策略的轶事报道。
方法
我们回顾了在单一中心对晚期心力衰竭（HF）患者采用替代策略植入HeartMate II和HeartWare CF-LVAD的经验。这篇特色文章聚焦于相关手术技术及患者管理中的陷阱。
结果
对于适当选择的病例，我们团队认为这些替代策略有助于开发用于CF-LVAD植入的新颖且创伤较小的手术方法。凭借可重复的结果，这些方法也有望增加能够从CF-LVAD治疗中获益的高风险手术患者数量。
结论
这项工作详细阐述了多种用于长期LVAD植入的侵入性较小的替代策略。这些更新的方法在心胸外科领域有显著进展的潜力。需要大规模的协作研究来阐明这些新技术对患者预后的潜在优缺点。
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