Kalathiya Rohan J, Grinstein Jonathan, Uriel Nir, Shah Atman P
The University of Chicago Medicine, 5841 S. Maryland Ave, MC 6080, Chicago, IL 60637 USA.
J Invasive Cardiol. 2017 May;29(5):151-162. Epub 2017 Feb 15.
Heart failure is a growing epidemic in the United States and throughout the world. The utilization of continuous-flow left ventricular assist devices (LVADs) has greatly increased over the last decade. In addition, a limited supply of organ donors has led to a rise in the use, and duration, of LVADs for destination therapy. The increased use of LVAD therapy has led to the observation of mechanical complications such as device thrombosis, de novo aortic insufficiency, and outflow graft stenosis, all of which are associated with prolonged LVAD support. Surgical repair for these complications remains the therapy of choice; however, surgery may be associated with high operative risk in some patients. The purpose of this article is to discuss mechanical complications associated with LVAD therapy and interventional transcatheter therapies that have been used to solve these increasingly complex problems.
心力衰竭在美国乃至全世界都是一种日益流行的疾病。在过去十年中，连续流左心室辅助装置（LVAD）的使用大幅增加。此外，器官捐献者供应有限导致用于终末期治疗的LVAD使用量及其使用时长有所增加。LVAD治疗使用的增加导致了一些机械并发症的出现，如装置血栓形成、新发主动脉瓣关闭不全和流出道移植物狭窄，所有这些都与LVAD的长期支持有关。针对这些并发症的手术修复仍然是首选治疗方法；然而，在一些患者中，手术可能伴随着高手术风险。本文的目的是讨论与LVAD治疗相关的机械并发症以及用于解决这些日益复杂问题的介入性导管治疗。
