打造更好的心室辅助装置：要使机械循环支持在长期疗效方面真正能与心脏移植相竞争，需要具备哪些条件？
To build a better VAD: What is needed to make MCS truly competitive with cardiac transplantation for long-term outcomes?
作者信息
Cowger Jennifer A, Potapov Evgenij
机构信息
Department of Cardiovascular Medicine, Henry Ford Health, Michigan State University and Wayne State University, Detroit, MI.
Deutsches Herzzentrum der Charité, Department of Cardiothoracic and Vascular Surgery, Augustenburger Platz 1, 13353 Berlin, Germany.
出版信息
JHLT Open. 2025 Jun 20;9:100325. doi: 10.1016/j.jhlto.2025.100325. eCollection 2025 Aug.
While average survival in patients undergoing durable left ventricular assist device (dLVAD) support now approximate 6 years, the application of therapy remains limited across the globe. Herein we highlight important deficiencies common to present technology and propose device innovations and field corrections that will be necessary to improve acceptance of dLVAD support by both patients and medical providers caring for patients with end-stage heart failure. Pragmatic trials will also be needed to help identify the therapeutic strategy (permanent dLVAD support vs heart transplant vs dLVAD as a bridge to transplant) that affords the best outcomes for a patient's risk profile and total survival goals.
虽然接受持久性左心室辅助装置（dLVAD）支持的患者的平均生存期目前约为6年，但该疗法在全球的应用仍然有限。在此，我们强调当前技术普遍存在的重要缺陷，并提出设备创新和领域修正措施，这对于提高终末期心力衰竭患者及其护理医疗人员对dLVAD支持的接受度是必要的。还需要进行务实的试验，以帮助确定（永久性dLVAD支持与心脏移植 vs dLVAD作为移植桥梁）哪种治疗策略能为患者的风险状况和总生存目标带来最佳结果。
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