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HeartMate 3:结果分析与未来方向

HeartMate 3: Analysis of Outcomes and Future Directions.

机构信息

Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.

Department of Anesthesiology, Boston Medical Center, Boston, MA.

出版信息

J Cardiothorac Vasc Anesth. 2024 Dec;38(12):3224-3233. doi: 10.1053/j.jvca.2024.08.016. Epub 2024 Aug 15.

Abstract

Heart failure (HF) remains a public health concern affecting millions of individuals worldwide. Despite recent advances in device-related therapies, the prognosis for patients with chronic HF remains poor with significant long-term risk of morbidity and mortality. Left ventricular assist devices (LVADs) have transformed the landscape of advanced HF management, offering circulatory support as destination therapy or as a bridge for heart transplantation. Among the latest generation of LVADs, the HeartMate 3 has gained popularity due to improved clinical outcomes and lower risk of serious adverse events when compared with previous similar devices. The ELEVATE (Evaluating the HeartMate 3 with Full MagLev Technology in a Post-Market Approval Setting) Registry and the MOMENTUM 3 (Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy with HeartMate 3) trial represent landmark investigations into the performance and comparative effectiveness of the HeartMate 3 LVAD. This review provides a comprehensive synthesis of the safety and efficacy of the 2-year and 5-year HeartMate LVAD outcomes, highlighting key findings, methodological considerations, implications for clinical practice, and future directions.

摘要

心力衰竭(HF)仍然是一个公共卫生问题,影响着全球数以百万计的人。尽管最近在设备相关治疗方面取得了进展,但慢性 HF 患者的预后仍然不佳,长期存在发病率和死亡率的显著风险。左心室辅助装置(LVAD)改变了晚期 HF 管理的格局,为患者提供循环支持,作为终末期治疗或心脏移植的桥梁。在最新一代的 LVAD 中,HeartMate 3 由于与之前类似设备相比,具有更好的临床结局和更低的严重不良事件风险,因此广受欢迎。ELEVATE(在上市后批准环境中评估具有全磁悬浮技术的 HeartMate 3)注册研究和 MOMENTUM 3(使用 HeartMate 3 进行机械循环支持治疗的患者中磁悬浮技术的多中心研究)试验代表了对 HeartMate 3 LVAD 的性能和比较有效性的重要研究。这篇综述全面综合了 HeartMate LVAD 两年和五年的安全性和疗效,重点介绍了关键发现、方法学考虑、对临床实践的影响和未来方向。

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