左心室辅助装置植入术后的右心衰竭：一个持续存在的问题。
Right heart failure after left ventricular assist device implantation: a persistent problem.
作者信息
Siems Chesney, Aggarwal Rishav, Shaffer Andrew, John Ranjit
机构信息
Division of Cardiothoracic Surgery, Department of Surgery, University of Minnesota, 420 Delaware Street SE, MMC 207, Minneapolis, MN 55455 USA.
出版信息
Indian J Thorac Cardiovasc Surg. 2023 Jul;39(Suppl 1):161-169. doi: 10.1007/s12055-023-01481-z. Epub 2023 Feb 22.
Abstract
Left ventricular assist device (LVAD) is an option for bridge-to-transplant or destination therapy for patients with end-stage heart failure. Right heart failure (RHF) remains a complication after LVAD implantation that portends high morbidity and mortality, despite advances in LVAD technology. Definitions of RHF vary, but generally include the need for inotropic or pulmonary vasodilator support, or potential right ventricular (RV) mechanical circulatory support. This review covers the complex pathophysiology of RHF related to underlying myocardial dysfunction, interventricular dependence, and RV afterload, as well as treatment strategies to curtail this challenging problem.
摘要
左心室辅助装置（LVAD）是终末期心力衰竭患者桥接至移植或目标治疗的一种选择。尽管LVAD技术有所进步，但右心衰竭（RHF）仍是LVAD植入后的一种并发症，预示着高发病率和死亡率。RHF的定义各不相同，但通常包括需要使用正性肌力药物或肺血管扩张剂支持，或潜在的右心室（RV）机械循环支持。本综述涵盖了与潜在心肌功能障碍、心室间依赖和RV后负荷相关的RHF复杂病理生理学，以及解决这一具有挑战性问题的治疗策略。
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