Kapur Navin K, Esposito Michele
The Cardiovascular Center, Tufts Medical Center, 800 Washington Street, BOX 80, Boston, MA 02111, USA.
The Cardiovascular Center, Tufts Medical Center, 800 Washington Street, BOX 80, Boston, MA 02111, USA.
Heart Fail Clin. 2015 Apr;11(2):215-30. doi: 10.1016/j.hfc.2014.12.012. Epub 2015 Feb 21.
The use of surgically implanted durable mechanical circulatory support (MCS) in high-risk patients with heart failure is declining and short-term, nondurable MCS device use is growing. Percutaneously delivered MCS options for advanced heart failure include the intra-aortic balloon pump, Impella axial flow catheter, TandemHeart centrifugal pump, and venoarterial extracorporeal membrane oxygenation. Nondurable MCS devices have unique implantation characteristics and hemodynamic effects. Algorithms and guidelines for optimal nondurable MCS device selection do not exist. Emerging technologies and applications will address the need for improved left ventricular unloading using lower-profile devices, longer-term ambulatory support, and the potential for myocardial recovery.
在高危心力衰竭患者中，外科植入的耐用机械循环支持（MCS）的使用正在减少，而短期、非耐用MCS设备的使用正在增加。晚期心力衰竭的经皮MCS选项包括主动脉内球囊泵、Impella轴流导管、TandemHeart离心泵和静脉-动脉体外膜肺氧合。非耐用MCS设备具有独特的植入特性和血流动力学效应。不存在用于最佳非耐用MCS设备选择的算法和指南。新兴技术和应用将满足使用更小型化设备改善左心室卸载、长期门诊支持以及心肌恢复潜力的需求。
