老年人心室辅助装置植入术
Ventricular assist device implantation in the elderly.
作者信息
Hiesinger William, Boyd Jack H, Woo Y Joseph
机构信息
1 Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA, USA ; 2 Division of Cardiothoracic Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA ; 3 Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA.
出版信息
Ann Cardiothorac Surg. 2014 Nov;3(6):570-2. doi: 10.3978/j.issn.2225-319X.2014.09.07.
BACKGROUND
Dramatic advances in ventricular assist device (VAD) design and patient management have made mechanical circulatory support an attractive therapeutic option for the growing pool of elderly heart failure patients.
METHODS
A literature review of all relevant studies was performed. No time or language restrictions were imposed, and references of the selected studies were checked for additional relevant citations.
RESULTS
In concordance with the universal trend in mechanical circulatory support, continuous flow devices appear to have particular benefits in the elderly. In addition, the literature suggests that early intervention before the development of cardiogenic shock, important in all patients, is particularly paramount in older patients.
CONCLUSIONS
The ongoing refinement of patient selection, surgical technique, and post-operative care will continue to improve surgical outcomes, and absolute age may become a less pivotal criterion for mechanical circulatory support. However, clear guidelines for the use of mechanical circulatory support in the elderly remain undefined.
背景
心室辅助装置（VAD）设计和患者管理方面的显著进展，使机械循环支持成为越来越多老年心力衰竭患者颇具吸引力的治疗选择。
方法
对所有相关研究进行文献综述。未设时间或语言限制，并检查所选研究的参考文献以获取更多相关引用。
结果
与机械循环支持的普遍趋势一致，连续流装置似乎对老年人有特别的益处。此外，文献表明，在所有患者中，在心源性休克发生前进行早期干预很重要，而在老年患者中尤为关键。
结论
患者选择、手术技术和术后护理的不断完善将继续改善手术效果，绝对年龄可能会成为机械循环支持中不那么关键的标准。然而，老年人使用机械循环支持的明确指南仍未确定。
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