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[机械循环支持挽救生命——匈牙利布达佩斯塞梅尔维斯大学新设立的辅助装置项目三年经验]

[Mechanical circulatory support saves lives -- three years' experience of the newly established assist device program at Semmelweis University, Budapest, Hungary].

作者信息

Fazekas Levente, Sax Balázs, Hartyánszky István, Pólos Miklós, Horkay Ferenc, Varga Tamás, Rácz Kristóf, Németh Endre, Székely Andrea, Paulovich Erzsébet, Heltai Krisztina, Zima Endre, Szabolcs Zoltán, Merkely Béla

机构信息

Semmelweis Egyetem, Általános Orvostudományi Kar Városmajori Szív- és Érgyógyászati Klinika Budapest Városmajor u. 68. 1122.

Semmelweis Egyetem, Általános Orvostudományi Kar Aneszteziológiai és Intenzív Terápiás Klinika Budapest.

出版信息

Orv Hetil. 2015 Mar 29;156(13):521-7. doi: 10.1556/OH.2015.30115.

Abstract

INTRODUCTION

Since the celebration of the 20th anniversary of the first heart transplantation in Hungary in 2012 the emerging need for modern heart failure management via mechanical circulatory support has evolved. In May 2012 the opening of a new heart failure and transplant unit with 9 beds together with the procurement of necessary devices at Semmelweis University accomplished this need.

AIM

The aim of the authors was to report their initial experience obtained in this new cardiac assist device program.

METHOD

Since May, 2012, mechanical circulatory support system was applied in 89 cases in 72 patients. Indication for support were end stage heart failure refractory to medical treatment and acute left or right heart failure.

RESULTS

Treatment was initiated for acute graft failure after heart transplantation in 27 cases, for end stage heart failure in 24 cases, for acute myocardial infarction in 21 cases, for acute postcardiotomy heart failure in 14 cases, for severe respiratory insufficiency in 2 cases and for drug intoxication in one case. Among the 30 survivor of the whole program 13 patients were successfully transplanted.

CONCLUSIONS

The available devices can cover all modalities of current bridge therapy from short term support through medium support to heart transplantation or long term support and destination therapy. These conditions made possible the successful start of a new cardiac assist device program.

摘要

引言

自2012年匈牙利首次心脏移植20周年庆祝活动以来,通过机械循环支持进行现代心力衰竭管理的新需求不断演变。2012年5月,塞梅尔维斯大学开设了一个拥有9张床位的新心力衰竭与移植单元,并购置了必要设备,满足了这一需求。

目的

作者旨在报告他们在这个新的心脏辅助装置项目中获得的初步经验。

方法

自2012年5月以来,72例患者中的89例应用了机械循环支持系统。支持的指征为药物治疗难治的终末期心力衰竭以及急性左心或右心衰竭。

结果

27例因心脏移植后急性移植物功能衰竭接受治疗,24例因终末期心力衰竭接受治疗,21例因急性心肌梗死接受治疗,14例因心脏术后急性心力衰竭接受治疗,2例因严重呼吸功能不全接受治疗,1例因药物中毒接受治疗。在整个项目的30名幸存者中,13例患者成功接受了移植。

结论

现有的设备可以涵盖当前桥接治疗的所有模式,从短期支持到中期支持,再到心脏移植或长期支持以及目标治疗。这些条件使得一个新的心脏辅助装置项目得以成功启动。

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