Loyaga-Rendon Renzo Y, Jani Milena, Fermin David, McDermott Jennifer K, Vancamp Diane, Lee Sangjin
Advanced Heart Failure and Heart Transplantation Section, Spectrum Health, 330 Barclay Avenue NE, Suite 200, MC258, Grand Rapids, MI, 49503, USA.
Curr Heart Fail Rep. 2017 Dec;14(6):465-477. doi: 10.1007/s11897-017-0367-3.
The purpose of this review is to describe the current knowledge in prevention and treatment of thrombotic (pump thrombosis and ischemic stroke) and bleeding (gastrointestinal and hemorrhagic stroke) complications in patients supported by continuous-flow left ventricular assist devices (CF-LVAD).
Left ventricular assist devices (LVADs) are now widely used for the management of end-stage heart failure. Unfortunately, in spite of the indisputable positive impact LVADs have on patients, the frequency and severity of complications are limitations of this therapy. Stroke, pump thrombosis, and gastrointestinal bleeding are among the most serious and frequent complications in these patients. The balance between hemorrhagic and thrombotic complications in patients supported with CF-LVAD is difficult as most patients do not necessarily fit a "bleeder" or a "clotter" profile but rather move from one side to the other of the thrombotic/bleeding spectrum. Further research is necessary to better understand the risk factors and mechanisms involved in the development of these complications.
本综述旨在描述在连续流左心室辅助装置（CF-LVAD）支持下的患者中，血栓形成（泵血栓形成和缺血性卒中）和出血（胃肠道出血和出血性卒中）并发症的预防和治疗方面的现有知识。
左心室辅助装置（LVAD）目前广泛用于终末期心力衰竭的治疗。不幸的是，尽管LVAD对患者有不可争议的积极影响，但并发症的发生率和严重程度仍是该治疗方法的局限性。卒中、泵血栓形成和胃肠道出血是这些患者中最严重且最常见的并发症。对于接受CF-LVAD支持的患者，出血性和血栓形成性并发症之间的平衡难以把握，因为大多数患者不一定符合“出血者”或“凝血者”的特征，而是在血栓形成/出血谱的一侧向另一侧转变。需要进一步研究以更好地了解这些并发症发生发展过程中的危险因素和机制。
