Vollman M W
Surgical Intensive Care Unit, Veterans Administration Medical Center, St. Louis, Missouri, USA.
Prog Cardiovasc Nurs. 1995 Spring;10(2):15-22.
Historically, heart transplantation has served as the definitive treatment of choice for patients with end-stage heart failure. Unfortunately, heart transplantation is not available to all patients because of the scarcity of donor allografts and strict patient selection criteria. Dynamic cardiomyoplasty is an experimental alternative to heart transplantation for the treatment of severe congestive heart failure and dilated cardiomyopathy. The procedure involves the use of an autologous latissimus dorsi muscle graft that is wrapped around the ventricles by pericardial attachment. The muscle graft is then stimulated by specialized synchronous train impulses from a cardiomyostimulator; the resultant muscle graft contractions provide support for ventricular function. This article describes collaborative, preoperative, immediate postoperative, and long-term management of patients receiving dynamic cardiomyoplasty. As members of the health care team, nurses are in a unique position to develop care standards and facilitate multidisciplinary collaboration for the care of this complex patient population.
从历史上看，心脏移植一直是终末期心力衰竭患者的首选确定性治疗方法。不幸的是，由于供体同种异体移植物稀缺以及严格的患者选择标准，并非所有患者都能进行心脏移植。动态心肌成形术是治疗严重充血性心力衰竭和扩张型心肌病的一种替代心脏移植的实验性方法。该手术包括使用自体背阔肌移植物，通过心包附着将其包裹在心室周围。然后，肌肉移植物由心肌刺激器发出的专门同步序列脉冲进行刺激；由此产生的肌肉移植物收缩为心室功能提供支持。本文描述了接受动态心肌成形术患者的协作性、术前、术后即刻及长期管理。作为医疗团队的成员，护士在制定护理标准以及促进对这一复杂患者群体的多学科协作方面具有独特的地位。
