Advanced Heart Failure and Cardiac Transplant, Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, 473 West 12th Avenue, Suite 200 DHLRI, Columbus, OH 43221, USA.
Crit Care Clin. 2018 Jul;34(3):465-477. doi: 10.1016/j.ccc.2018.03.003.
Heart failure patients on durable left ventricular assist device support experience improved survival, quality of life, and exercise capacity. The complication rate, however, remains unacceptably high, although it has declined with improvements in pump design, better patient selection, and greater understanding of the pump physiology and flow dynamics. Most complications are categorized as those related to the pump-patient interface or those related to patient physiology. It is hoped that further engineering progress, and better patient selection through risk stratification, will allow for left ventricular assist device to be totally biocompatible and perform effectively, without affecting biology and homeostasis of the different organ systems.
接受耐用型左心室辅助装置支持的心力衰竭患者的生存率、生活质量和运动能力均得到改善。然而,尽管随着泵设计的改进、更好的患者选择以及对泵生理学和流动动力学的更深入了解,并发症发生率有所下降,但仍高得无法接受。大多数并发症可分为与泵-患者接口相关的并发症和与患者生理相关的并发症。人们希望通过工程学的进一步进步,以及通过风险分层对患者进行更好的选择,使得左心室辅助装置完全具有生物相容性,并能有效地发挥作用,而不会影响不同器官系统的生物学和内稳态。