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机械循环支持在急性心肌梗死治疗中的作用。

Role of Mechanical Circulatory Support in Acute MI Management.

作者信息

Kumar Sundeep, Feroze Rafey, Forouzandeh Farshad

机构信息

University Hospitals Harrington Heart Vascular Institute, Case Western Reserve University School of Medicine Cleveland, OH.

Case Western Reserve University School of Medicine Cleveland, OH.

出版信息

US Cardiol. 2023 Apr 28;17:e04. doi: 10.15420/usc.2022.32. eCollection 2023.

Abstract

Cardiogenic shock complicating acute MI carries high mortality and morbidity in many cases. Mechanical circulatory support devices are often used in these cases, aimed at improving patient-centered outcomes, although there is a lack of large randomized clinical trial-based evidence for many of such devices. Various circulatory support devices are available with their associated risks and benefits. Ideal circulatory support device intends to unload the myocardium, halt the spiral of ischemia, provide support for revascularization, and/or allow time for myocardial recovery. In this review paper, the commonly used mechanical circulatory support devices available for use in acute myocardial infarction settings are discussed, and the pros and cons of these devices are examined, considering the contemporary data for each. While this is an evolving field, the authors believe this paper can be helpful to review the current status of the use of mechanical support devices in the setting of acute MI and highlight some of the unmet needs in this field.

摘要

心源性休克并发急性心肌梗死在许多情况下具有很高的死亡率和发病率。在这些病例中,常使用机械循环支持装置,旨在改善以患者为中心的治疗结果,尽管许多此类装置缺乏基于大型随机临床试验的证据。有各种循环支持装置,它们都有各自的风险和益处。理想的循环支持装置旨在减轻心肌负荷、阻止缺血螺旋式发展、为血管重建提供支持和/或为心肌恢复争取时间。在这篇综述文章中,讨论了可用于急性心肌梗死情况的常用机械循环支持装置,并结合每种装置的当代数据审视了这些装置的优缺点。虽然这是一个不断发展的领域,但作者认为本文有助于回顾急性心肌梗死情况下机械支持装置的使用现状,并突出该领域一些未满足的需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c274/11526479/a879afaba751/usc-17-e04-g001.jpg

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