Dhakal Bishnu P, Oliveira Guilherme H
Harrington Heart and Vascular Institute, Division of Heart Failure and Cardiac Transplant, Department of Medicine University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Avenue, Mailstop LKS 5038, Cleveland, OH, 44106, USA.
Curr Heart Fail Rep. 2017 Apr;14(2):87-99. doi: 10.1007/s11897-017-0326-z.
Percutaneous ventricular restoration with a ventricular partitioning device (VPD) is a novel minimally invasive procedure designed to restore the left ventricular (LV) shape by isolating the infarcted and aneurysmal LV apex from remainder of the cavity in heart failure patients with severely reduced LV ejection fraction. In this review, we perform an in-depth analysis of the design and purpose of the VPD and review the available clinical data, with special attention to hemodynamics, outcomes, and complications.
PARACHUTE trials have shown >90% procedural success rate of VPD implant. Heart failure patients had improvement in hemodynamics (reduction in LV volumes and increase in LV ejection fraction) and functional status (6-min walking distance and quality of life scores) after the VPD implant. Optimal implant position is necessary to obtain a good clinical outcome. Percutaneous VPD implantation has thus far been a safe intervention capable of improving surrogate markers of heart failure but there is still a need to develop more durable devices with a long-lasting hemodynamics effect.
使用心室分隔装置（VPD）进行经皮心室修复是一种新型的微创手术，旨在通过将梗死和动脉瘤样的左心室（LV）心尖与左心室射血分数严重降低的心力衰竭患者的心腔其余部分隔离开来，恢复左心室（LV）形状。在本综述中，我们对VPD的设计和目的进行了深入分析，并回顾了现有的临床数据，特别关注血流动力学、结果和并发症。
PARACHUTE试验表明VPD植入的手术成功率>90%。VPD植入后，心力衰竭患者的血流动力学（左心室容积减少，左心室射血分数增加）和功能状态（6分钟步行距离和生活质量评分）得到改善。为获得良好的临床结果，最佳植入位置是必要的。迄今为止，经皮VPD植入是一种能够改善心力衰竭替代指标的安全干预措施，但仍需要开发具有持久血流动力学效应的更耐用装置。
