Mohamed Ambreen, Mehta Natasha, Eisen Howard J
Division of Cardiology, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
Curr Opin Organ Transplant. 2017 Jun;22(3):231-235. doi: 10.1097/MOT.0000000000000418.
Cardiac transplant remains the gold standard of care for patients with end-stage heart failure. Unfortunately, due to the limited availability of donor hearts in the United States, not all eligible candidates are able to be transplanted. Since the introduction of mechanical assist devices for the treatment of advanced heart failure, patients gain a significant survival benefit while awaiting transplant. With rapidly evolving technology, it is important to appreciate the advances in the current use of mechanical assist devices.
Following a comprehensive analysis of novel therapies in end-stage heart failure, there is an enhancement in quality of life and life expectancy following implantation of left ventricular (LV) assist devices (LVADs). When implanted in suitable patients as bridge-to-transplant or 'destination therapy', recipients demonstrate superior outcomes and survival compared with those who remain on optimal medical therapy.
The use of LV assist devices (LVADs) as bridge to transplantation has gained popularity over the last decade. It is recognized as an integral treatment modality in end-stage heart failure to those awaiting heart transplantation. When implanted in the appropriately chosen patient, it is superior to medical treatment alone and has shown noninferiority to heart transplantation while allowing for optimal functional status and preservation of end organ function.
心脏移植仍然是终末期心力衰竭患者治疗的金标准。不幸的是，由于美国供体心脏供应有限，并非所有符合条件的候选者都能接受移植。自从引入用于治疗晚期心力衰竭的机械辅助装置以来，患者在等待移植期间获得了显著的生存益处。随着技术的迅速发展，了解当前机械辅助装置使用方面的进展非常重要。
在对终末期心力衰竭的新疗法进行全面分析后发现，植入左心室辅助装置（LVAD）后，生活质量和预期寿命有所提高。当作为桥接移植或“目标治疗”植入合适的患者体内时，与接受最佳药物治疗的患者相比，接受者显示出更好的结果和生存率。
在过去十年中，使用左心室辅助装置（LVAD）作为移植桥梁越来越普遍。它被认为是等待心脏移植的终末期心力衰竭患者不可或缺的治疗方式。当植入适当选择的患者体内时，它优于单纯药物治疗，并且在允许最佳功能状态和保留终末器官功能的同时，显示出与心脏移植相当的效果。
