Vargo R, Dimengo J M
AACN Clin Issues Crit Care Nurs. 1993 May;4(2):244-59.
Chronic heart failure is a progressive syndrome characterized by diffuse coronary artery disease (CAD) or left ventricular failure not amenable to acute interventions of myocardial revascularization. A spectrum of treatment options is available to such patients. Medical therapies consist largely of pharmacologic alternatives and are used in the early stages of heart failure to slow the processes of ventricular remodeling. Surgical interventions are used as adjunctive therapies in the later stages of heart failure. These procedures include coronary endarterectomy, high-risk surgical revascularization, automatic internal cardioverter-defibrillator insertion (Coronary Artery Bypass Grafting in Conjunction with Implantable Cardioverter Defibrillator Trial), cardiac transplantation, and dynamic cardiomyoplasty. This article provides an overview of each of these surgical therapies. Indications for each procedure and patient selection criteria are outlined. A description of each surgical procedure is included. Guidelines for postoperative nursing care are provided, and postoperative complications are discussed.
慢性心力衰竭是一种进行性综合征，其特征为弥漫性冠状动脉疾病（CAD）或左心室衰竭，无法通过心肌血运重建的急性干预措施进行治疗。这类患者有一系列治疗选择。药物治疗主要包括药理学替代方法，用于心力衰竭的早期阶段，以减缓心室重塑进程。手术干预则在心力衰竭的后期用作辅助治疗。这些手术包括冠状动脉内膜切除术、高风险手术血运重建、自动体内心脏复律除颤器植入（冠状动脉旁路移植术联合植入式心脏复律除颤器试验）、心脏移植和动力性心肌成形术。本文概述了这些手术治疗方法中的每一种。概述了每种手术的适应证和患者选择标准。包括了每种手术的描述。提供了术后护理指南，并讨论了术后并发症。
