Department of Anesthesiology and Perioperative Medicine, Division of Cardiovascular Anesthesiology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA.
Department of Anesthesiology and Perioperative Medicine, Division of Cardiovascular Anesthesiology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA.
J Cardiothorac Vasc Anesth. 2021 Jul;35(7):2194-2200. doi: 10.1053/j.jvca.2021.02.003. Epub 2021 Feb 6.
Surgical ventricular remodeling (SVR) is an invasive method of treating patients with heart failure who also have ischemic cardiomyopathy and reduced ejection fraction (EF). Introduced in the mid-1980s, this technique was met with varying success and relatively high morbidity and mortality despite its theoretical benefits. The development of the BioVentrix Revivent TC System (BioVentrix, Inc., San Ramon, CA) as a less-invasive method of surgical ventricular remodeling has created a novel, multidisciplinary approach to heart failure management, which necessitates multiple subspecialties. Currently in the trial phase in the United States and widely used in Europe, the positive results to date appear promising for the rapid adoption of this procedure. For the cardiac anesthesiologist, a thorough understanding of the patient population, procedural goals, and intraoperative management is essential. This overview discusses the advancement in surgical ventricular remodeling, the pertinent surgical steps of the BioVentrix Revivent TC System placement, and specific anesthetic considerations for this novel procedure.
外科心室重构（SVR）是一种有创方法，用于治疗同时患有缺血性心肌病和射血分数降低（EF）的心力衰竭患者。该技术于 20 世纪 80 年代中期推出，尽管具有理论上的益处，但成功率各不相同，且发病率和死亡率相对较高。BioVentrix Revivent TC 系统（BioVentrix，Inc.，加利福尼亚州圣拉蒙）的开发作为一种微创的外科心室重构方法，为心力衰竭管理创造了一种新的多学科方法，需要多个亚专业。目前该方法正在美国进行临床试验阶段，在欧洲广泛使用，迄今为止的积极结果为该手术的快速采用提供了希望。对于心脏麻醉医生而言，全面了解患者人群、手术目标和术中管理至关重要。本文综述了外科心室重构的进展、BioVentrix Revivent TC 系统放置的相关手术步骤以及该新手术的具体麻醉注意事项。
