Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia.
Circulation. 2018 Dec 11;138(24):2841-2851. doi: 10.1161/CIRCULATIONAHA.118.035566.
Ventricular assist device has rapidly emerged as a durable and safe therapy for end-stage heart failure patients with >22 000 implantations to date. Though originally conceived for bridge-to-transplant indication, significant advancements in medical management as well as technology with arrivals of newer generation devices have improved patient outcomes, leading to increasing use as destination therapy. Despite such improvement, however, the burden of adverse events remains significant and defines the most pressing issue in the current state of ventricular assist device therapy. Eventual use of ventricular assist device technology as a comparable alternative to heart transplantation will ultimately rely on our ability to mitigate these risks. Therefore, this review article provides the narrative surrounding the rapid integration of this technology into the heart failure paradigm, specifically in the context of the most recent data on its outcomes and adverse event profiles. It describes ongoing investigations and general trends that may have significant implications for future improvements in device-related outcomes, as the field continues to grow as the epitome of synergy between advancements in engineering and clinical medicine.
心室辅助装置作为一种耐用且安全的治疗方法，已经迅速成为晚期心力衰竭患者的选择，目前已有超过 22000 例植入。尽管最初是为移植桥接适应证而设计的，但随着新一代设备的出现，在医疗管理和技术方面取得了重大进展，改善了患者的预后，导致作为终末期治疗的应用越来越多。然而，尽管取得了这些进展，不良事件的负担仍然很大，并定义了心室辅助装置治疗的当前最紧迫问题。最终将心室辅助装置技术用作心脏移植的可比较替代方法，将取决于我们减轻这些风险的能力。因此，本文综述了该技术在心力衰竭治疗领域的迅速整合，特别是在该技术最近的预后和不良事件数据方面。它描述了正在进行的研究和一般趋势，这些可能对未来改善与设备相关的结果具有重要意义，因为该领域继续成为工程学和临床医学进步之间协同作用的典范。
