Roesel Maximilian J, Nersesian Gaik, Neuber Sebastian, Thau Henriette, Wolff von Gudenberg Rosalie, Lanmueller Pia, Hennig Felix, Falk Volkmar, Potapov Evgenij, Knosalla Christoph, Iske Jasper
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité (DHZC), 13353 Berlin, Germany.
Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.
Rev Cardiovasc Med. 2024 May 17;25(5):176. doi: 10.31083/j.rcm2505176. eCollection 2024 May.
Heart failure (HF) is a common disease associated with high morbidity and mortality rates despite advanced pharmacological therapies. Heart transplantation remains the gold standard therapy for end-stage heart failure; however, its application is curtailed by the persistent shortage of donor organs. Over the past two decades, mechanical circulatory support, notably Left Ventricular Assist Devices (LVADs), have been established as an option for patients waiting for a donor organ. This comprehensive review focuses on elucidating the benefits and barriers associated with this application. We provide an overview of landmark clinical trials that have evaluated the use of LVADs as a bridge to transplantation therapy, with a particular focus on post-transplant outcomes. We discuss the benefits of stabilizing patients with these systems, weighing associated complications and limitations. Further technical advancements and research on optimal implantation timing are critical to ultimately improve outcomes and securing quality of life. In a world where the availability of donor organs remains constrained, LVADs are an increasingly important piece of patient care, bridging the critical gap to transplantation in advanced heart failure management.
尽管有先进的药物治疗方法,但心力衰竭(HF)仍是一种发病率和死亡率都很高的常见疾病。心脏移植仍然是终末期心力衰竭的金标准治疗方法;然而,供体器官的持续短缺限制了其应用。在过去二十年中,机械循环支持,特别是左心室辅助装置(LVAD),已成为等待供体器官患者的一种选择。这篇综述着重阐明与该应用相关的益处和障碍。我们概述了评估LVAD作为移植治疗桥梁用途的里程碑式临床试验,特别关注移植后的结果。我们讨论了使用这些系统稳定患者的益处,并权衡相关并发症和局限性。进一步的技术进步以及对最佳植入时机的研究对于最终改善治疗结果和确保生活质量至关重要。在供体器官可用性仍然受限的情况下,LVAD在晚期心力衰竭管理中是患者护理的一个越来越重要的组成部分,弥合了到移植的关键差距。