Bories Marie-Cécile, Abi Akar Ramzi
Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France.
Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
Eur Heart J Suppl. 2020 Dec 23;22(Suppl Pt t):P33-P37. doi: 10.1093/eurheartj/suaa183. eCollection 2020 Dec.
Since the earliest cases of coronavirus disease 2019 (COVID-19) infection were reported, our care delivery systems have been reorganized and challenged in unprecedent ways, specifically the cardiovascular community. COVID-19 poses a challenge for heart transplantation, affecting donor selection, immunosuppression, and posttransplant management. Left Ventricular Assist Device (LVAD) therapy is currently a viable option for patients with end-stage heart failure as a bridge to heart transplantation or destination therapy. Here, we present a therapeutic strategy for the management of acute HF with Intermacs profiles from 1 to 4, with or without Covid-19 infection, exemplified by serie of patients presenting with severe HF and successfully treated by LVAD therapy during the spread of the Covid-19 pandemic and the French national lockdown. This experience has shown that we still have the capacity to provide the right therapy for the right disease to the right patient. LVAD implantation seems to be the treatment of choice for advanced HF due to the lack of healthy donor hearts for cardiac transplantation. Covid or non-Covid context, we have to take care of our patients with end-stage HF the best we can.
自2019年冠状病毒病（COVID-19）感染的首批病例报告以来，我们的医疗服务系统以前所未有的方式进行了重组并面临挑战，心血管领域尤其如此。COVID-19对心脏移植构成挑战，影响供体选择、免疫抑制和移植后管理。左心室辅助装置（LVAD）治疗目前是终末期心力衰竭患者作为心脏移植桥梁或目标治疗的可行选择。在此，我们提出一种治疗策略，用于管理Intermacs分级为1至4级的急性心力衰竭患者，无论是否感染Covid-19，以一系列在Covid-19大流行和法国全国封锁期间出现严重心力衰竭并通过LVAD治疗成功治疗的患者为例。这一经验表明，我们仍有能力为合适的患者针对合适的疾病提供正确的治疗。由于缺乏用于心脏移植的健康供体心脏，LVAD植入似乎是晚期心力衰竭的首选治疗方法。无论处于Covid还是非Covid背景下，我们都必须尽最大努力照顾终末期心力衰竭患者。
