Department of Cardiology, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma, USA. Electronic address: https://twitter.com/MohitpahujaMD.
Georgetown University School of Medicine, Washington, DC, USA.
J Am Coll Cardiol. 2022 Nov 22;80(21):2028-2049. doi: 10.1016/j.jacc.2022.08.807.
The use of mechanical circulatory support devices in cardiovascular practice has risen exponentially over the past decade. These devices are currently used for hemodynamic support in patients with cardiogenic shock, high-risk percutaneous coronary intervention, left ventricular unloading, protection of kidneys, and right ventricular failure. The Impella (Abiomed) percutaneous microaxial flow pump devices are rapidly gaining popularity. However, despite their increasing use, there are limited randomized clinical trials (RCTs) to support the benefits of the therapy and growing concern regarding complication rates. Vascular problems, including bleeding and acute limb ischemia, are associated with the devices, but published reports also highlight risks for cardiac perforations, mitral chordae rupture, and stroke. In this review, we summarize the history, mechanism of action, previously published RCT data, and upcoming RCTs on these devices.
在过去的十年中，机械循环支持装置在心血管实践中的应用呈指数级增长。这些装置目前用于心源性休克、高危经皮冠状动脉介入治疗、左心室卸载、肾脏保护和右心衰竭患者的血液动力学支持。Impella（Abiomed）经皮微轴流泵装置迅速普及。然而，尽管它们的使用越来越多，但支持治疗益处的随机临床试验（RCT）有限，并且对并发症发生率的担忧也在增加。血管问题，包括出血和急性肢体缺血，与这些装置有关，但已发表的报告还强调了心脏穿孔、二尖瓣腱索破裂和中风的风险。在这篇综述中，我们总结了这些装置的历史、作用机制、以前发表的 RCT 数据和即将进行的 RCT。
