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临时机械循环支持作为心脏移植或耐用左心室辅助装置的桥梁。

Temporary Mechanical Circulatory Support as a Bridge to Heart Transplant or Durable Left Ventricular Assist Device.

机构信息

Institute of Heart and Lung Transplant, Krishna Institute of Medical Sciences Hospitals, 1-8-31/1, Minister Road, Krishna Nagar Colony, Secunderabad, Telangana 500003, India.

Interventional Cardiology, AIG Institute of Cardiac Sciences and Research, 1, Mindspace Road, Gachibowli, Hyderabad, Telangana 500032, India.

出版信息

Interv Cardiol Clin. 2021 Apr;10(2):235-249. doi: 10.1016/j.iccl.2020.12.011.

Abstract

Advanced heart failure refractory to medical therapy can result in patients presenting with progressively worsening hypoperfusion and cardiogenic shock. Temporary mechanical circulatory support is often necessary as a bridge to heart transplant or durable ventricular assist devices. These devices increase cardiac output. Several options are available for left ventricular support. With the exception of venoarterial extracorporeal membrane oxygenation, all other devices decrease left ventricular end-diastolic pressure. The choice of device should be driven by patient needs and the treating teams comfort. Timely identification of cardiogenic shock and use of shock teams are potential strategies that can help improve survival.

摘要

对于药物难治性晚期心力衰竭患者,其心输出量逐渐减少,导致灌注不足和心原性休克。作为心脏移植或永久性心室辅助装置的过渡,通常需要临时机械循环支持。这些设备可以增加心输出量。左心室支持有几种选择。除了静脉动脉体外膜肺氧合(VA-ECMO)外,所有其他设备均降低左心室舒张末期压。设备的选择应根据患者的需求和治疗团队的舒适度来决定。及时识别心原性休克并使用休克团队是提高生存率的潜在策略。

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