Department of Cardiac Surgery, Center for Circulatory Support, Frankel Cardiovascular Center, University of Michigan, 5161 Cardiovascular Center, SPC 5864, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
Cardiol Clin. 2020 May;38(2):227-238. doi: 10.1016/j.ccl.2020.01.005. Epub 2020 Feb 28.
Durable left ventricular assist device therapy is an increasingly accepted surgical therapy for advanced heart failure refractory to guideline-directed medical therapy. Right heart failure is a known and frequent complication after durable left ventricular assist device implantation and remains an important clinical challenge. Medical management of right heart failure after left ventricular assist device therapy focuses on improving right ventricular contractility and optimizing right ventricular preload and afterload. Mechanical circulatory support options include surgical and percutaneous devices options as well as the total artificial heart or heart transplantation. Early institution of therapy is necessary to reduce the morbidity and mortality.
耐用型左心室辅助装置治疗是一种越来越被接受的治疗方法，适用于对指南指导的药物治疗无效的晚期心力衰竭。右心衰竭是耐用型左心室辅助装置植入后的已知且常见并发症，仍然是一个重要的临床挑战。左心室辅助装置治疗后的右心衰竭的医学管理侧重于改善右心室收缩力和优化右心室前负荷和后负荷。机械循环支持选择包括手术和经皮设备选择以及全人工心脏或心脏移植。早期开始治疗是降低发病率和死亡率的必要条件。
