Nayyar Mannu, Donovan Kevin Michael, Khouzam Rami N
Division of Cardiovascular Diseases, University of Tennessee Health Science Center, Memphis, TN, USA.
Ann Transl Med. 2018 Jan;6(1):9. doi: 10.21037/atm.2017.09.26.
Mechanical circulatory support (MCS) devices are continually evolving and are providing greater hemodynamic support. This review was conducted to evaluate the prophylactic use of MCS in hemodynamically stable patients who were awaiting future coronary artery revascularization. A thorough review of published literature was conducted to evaluate for patients and clinical scenarios that are indicated for MCS, including hemodynamically stable and unstable patients awaiting revascularization. Although there have been several studies demonstrating the benefit of MCS use in hemodynamically unstable patients, there was limited trials in patients that were hemodynamically stable. The use of prophylactic MCS was limited to intra-aortic balloon pump (IABP) in "high risk" patients awaiting coronary artery bypass grafting (CABG). This review article was conducted to evaluate for possible prophylactic MCS in patients awaiting revascularization. In hemodynamically stable patients, literature is limited to the use of IABP for "high-risk" patients awaiting CABG. A thorough review of literature suggest that hemodynamically stable patients likely would not benefit from prophylactic placement MCS while awaiting revascularization although further clinical trials are needed to identify the ideal patients and clinical scenarios for the use of MCS.
机械循环支持（MCS）设备在不断发展，并提供了更强的血流动力学支持。本综述旨在评估MCS在等待未来冠状动脉血运重建的血流动力学稳定患者中的预防性应用。对已发表文献进行了全面回顾，以评估适用于MCS的患者和临床情况，包括等待血运重建的血流动力学稳定和不稳定的患者。尽管已有多项研究证明MCS在血流动力学不稳定患者中使用的益处，但在血流动力学稳定的患者中进行的试验有限。预防性MCS的使用仅限于等待冠状动脉旁路移植术（CABG）的“高危”患者使用主动脉内球囊泵（IABP）。本综述文章旨在评估等待血运重建的患者中可能的预防性MCS。在血流动力学稳定的患者中，文献仅限于在等待CABG的“高危”患者中使用IABP。对文献的全面回顾表明，血流动力学稳定的患者在等待血运重建时可能无法从预防性放置MCS中获益，尽管需要进一步的临床试验来确定使用MCS的理想患者和临床情况。
