From the Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts.
Anesth Analg. 2018 Jun;126(6):1839-1850. doi: 10.1213/ANE.0000000000002669.
The pandemic of heart failure and the limited options for treatment of end-stage disease have resulted in an increase in the utilization of left ventricular assist devices (LVADs). Improvements in device technology and patient survival have led to an expanding population of patients requiring noncardiac surgery while on LVAD therapy, thus leading to a growing need for familiarity with the physiology of these patients. This review describes the functional mechanics of the most prevalent continuous-flow LVAD, the HeartMate II, and focuses on perioperative anesthetic concerns.
心力衰竭的流行和终末期疾病治疗选择的有限,导致左心室辅助装置(LVAD)的应用增加。设备技术的改进和患者存活率的提高导致越来越多的患者在接受 LVAD 治疗时需要接受非心脏手术,因此对这些患者的生理学有了更多的了解。本文介绍了最常见的连续血流 LVAD——HeartMate II 的功能力学,并重点介绍了围手术期麻醉相关问题。