Chung Joshua S, Emerson Dominic, Megna Dominick, Arabia Francisco A
Department of Cardiothoracic Surgery, Loma Linda University Health, Loma Linda, California, USA.
Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Ann Cardiothorac Surg. 2020 Mar;9(2):81-88. doi: 10.21037/acs.2020.02.09.
Heart failure is a complex, growing problem with significant morbidity and mortality. Though heart transplantation remains the gold standard treatment for end-stage heart failure, there remains a national shortage of donor hearts. Mechanical circulatory support has provided an additional option for clinicians to support patients for the purposes of bridging patients to transplantation or to be used for destination therapy purposes. Despite generally favorable outcomes with univentricular support, in a subset of patients with biventricular heart failure, an isolated left ventricular assist device is not sufficient. Right ventricular failure has a negative impact on patient survival if not identified and treated promptly. The Total Artificial Heart (TAH) is the only Food and Drug Administration (FDA) approved artificial heart used for bridging patients to transplantation. Outcomes in patients who undergo implantation of the TAH at experienced centers have been good and reproducible.
心力衰竭是一个复杂且日益严重的问题,具有显著的发病率和死亡率。尽管心脏移植仍然是终末期心力衰竭的金标准治疗方法,但全国范围内供体心脏短缺。机械循环支持为临床医生提供了另一种选择,以支持患者,目的是将患者过渡到移植或用于终末期治疗。尽管单心室支持总体效果良好,但在一部分双心室心力衰竭患者中,单独使用左心室辅助装置是不够的。如果右心室衰竭未得到及时识别和治疗,会对患者生存产生负面影响。全人工心脏(TAH)是唯一获得美国食品药品监督管理局(FDA)批准用于将患者过渡到移植的人工心脏。在经验丰富的中心接受TAH植入的患者预后良好且具有可重复性。