Rojas S V, Avsar M, Uribarri A, Hanke J S, Haverich A, Schmitto J D
Department of Cardiothoracic Transplantation, and Vascular Surgery Hannover Medical School, Hannover, Germany -
Minerva Chir. 2015 Feb;70(1):63-8. Epub 2015 Jan 23.
As the number of patients suffering of congestive heart failure is rising worldwide, the use of mechanical circulatory support to treat these patients has also grown enormously, surpassing the number of annual heart transplants. Moreover latest generation of left ventricular assist devices (LVADs) is characterized by improved technologies. Moreover the size of new LVAD systems is considerably reduced when compared to older generation devices. Therefore, less invasive surgery is now possible for the implantation, explantation, and exchange of LVADs. Although experience with these new techniques is still limited, minimally invasive procedures are thought to improve surgical outcomes by declining the rates of operative complications such as bleeding or wound infection. The miniaturization of LVADs will continue, so that minimally invasive techniques will be used for most LVAD-related procedures in the future. In this article, we summarize and describe minimally invasive surgical techniques, with a focus on the most common LVAD systems in adults.
随着全球范围内充血性心力衰竭患者数量的不断增加，使用机械循环支持来治疗这些患者的情况也大幅增长，超过了每年心脏移植的数量。此外，最新一代的左心室辅助装置（LVAD）具有改进的技术。而且，与旧一代装置相比，新型LVAD系统的尺寸大幅减小。因此，现在LVAD的植入、取出和更换手术可以采用创伤较小的方式。尽管这些新技术的经验仍然有限，但微创程序被认为可以通过降低出血或伤口感染等手术并发症的发生率来改善手术结果。LVAD的小型化将持续下去，以便未来大多数与LVAD相关的程序都将采用微创技术。在本文中，我们总结并描述了微创外科技术，重点关注成人中最常见的LVAD系统。
