Stollery Children's Hospital, Edmonton, Alberta, Canada.
The Hospital for Sick Children, Toronto, Ontario, Canada.
Can J Cardiol. 2022 Jul;38(7):1086-1099. doi: 10.1016/j.cjca.2022.03.012. Epub 2022 Mar 18.
Ventricular assist devices (VADs) are being increasingly used to support patients with congenital heart disease and single-ventricle physiology. Because of their unique anatomy and physiology, special consideration must be used to provide effective mechanical circulatory support for each individual patient. This can include alternative cannulation techniques, strategies to balance cardiac output to the systemic and pulmonary circulations from a single ventricle, or the use of continuous vs pulsatile VADs for better ventricular offloading. In this article we review the etiology of single-ventricle failure, VAD options for support, cannulation strategies, post-VAD management considerations, and outcomes at each of the 3 stages of palliation.
心室辅助装置(VAD)越来越多地用于支持患有先天性心脏病和单心室生理的患者。由于其独特的解剖结构和生理学特性,必须特别考虑为每个患者提供有效的机械循环支持。这可能包括替代插管技术、从单个心室平衡心输出量到体循环和肺循环的策略,或者使用连续 VAD 与搏动 VAD 以更好地减轻心室负担。本文综述了单心室衰竭的病因、VAD 支持的选择、插管策略、VAD 后管理注意事项以及每个姑息治疗阶段的结果。