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成人先天性心脏病的机械循环支持装置。

Mechanical circulatory support devices in adults with congenital heart disease.

机构信息

Johns Hopkins Hospital, Baltimore, Maryland.

Thomas Jefferson Hospital, Philadelphia, Pennsylvania, USA.

出版信息

Curr Opin Organ Transplant. 2024 Oct 1;29(5):310-315. doi: 10.1097/MOT.0000000000001165. Epub 2024 Aug 5.

Abstract

PURPOSE OF REVIEW

Mechanical circulatory support is used frequently as a method of stabilizing patients with end stage heart failure who are unable to safely await allograft availability. While this technology has been fundamentally important in supporting patients with normal cardiac anatomy, it is still used infrequently in adult patients with congenital heart disease and end-stage heart failure. Here, we review the data on mechanical circulatory support technology in this small but growing population of patients with chronic heart disease prone to the development of circulatory failure.

RECENT FINDINGS

Mechanical circulatory support (MCS) has been increasingly employed in adults with congenital heart disease (ACHD) as a bridge to transplant. The new United Network for Organ Sharing listing system favoring temporary MCS use with a higher listing status offers another tool to stabilize ACHD patients and potentially shorten wait times. Both temporary and Durable MCS could help improve transplant candidacy and posttransplant outcomes in select groups of ACHD patients.

SUMMARY

Durable and temporary MCS have the potential to significantly improve access to transplant and overall transplant outcomes in ACHD patients.

摘要

目的综述

机械循环支持常用于稳定终末期心力衰竭患者,这些患者无法安全等待供体器官。虽然这项技术对支持具有正常心脏解剖结构的患者至关重要,但在患有先天性心脏病和终末期心力衰竭的成年患者中仍不常使用。在这里,我们回顾了机械循环支持技术在这一小部分但不断增长的慢性心脏病患者群体中的数据,这些患者容易发生循环衰竭。

最近的发现

机械循环支持(MCS)越来越多地用于患有先天性心脏病(ACHD)的成年人,作为移植的桥梁。新的联合器官共享网络(UNOS)移植系统更倾向于使用临时 MCS 并给予更高的登记状态,这为稳定 ACHD 患者并可能缩短等待时间提供了另一种工具。临时和耐用性 MCS 都有可能改善某些 ACHD 患者的移植候选资格和移植后结果。

摘要

耐用性和临时性 MCS 有可能显著改善 ACHD 患者的移植机会和整体移植结果。

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