Department of Internal Medicine, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, FL, USA.
Department of Medicine, Cardiovascular Division, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, FL, USA.
Curr Cardiol Rev. 2023;19(5):27-42. doi: 10.2174/1573403X19666230314115853.
Temporary mechanical circulatory support (MCS) encompasses a wide array of invasive devices, which provide short-term hemodynamic support for multiple clinical indications. Although initially developed for the management of cardiogenic shock, indications for MCS have expanded to include prophylactic insertion prior to high-risk percutaneous coronary intervention, treatment of acute circulatory failure following cardiac surgery, and bridging of end-stage heart failure patients to more definitive therapies, such as left ventricular assist devices and cardiac transplantation. A wide variety of devices are available to provide left ventricular, right ventricular, or biventricular support. The choice of a temporary MCS device requires consideration of the clinical scenario, patient characteristics, institution protocols, and provider familiarity and training. In this review, the most common forms of left, right, and biventricular temporary MCS are discussed, along with their indications, contraindications, complications, cannulations, hemodynamic effects, and available clinical data.
临时机械循环支持(MCS)涵盖了广泛的侵入性设备,可为多种临床适应症提供短期血液动力学支持。尽管最初是为治疗心源性休克而开发的,但 MCS 的适应症已扩展到包括在高危经皮冠状动脉介入治疗前预防性插入、心脏手术后急性循环衰竭的治疗以及将终末期心力衰竭患者桥接到更明确的治疗方法,如左心室辅助装置和心脏移植。有多种设备可提供左心室、右心室或双心室支持。选择临时 MCS 设备需要考虑临床情况、患者特征、机构方案以及提供者的熟悉程度和培训。在这篇综述中,讨论了最常见的左、右和双心室临时 MCS 形式,以及它们的适应症、禁忌症、并发症、插管、血液动力学效应和可用的临床数据。