Myers T J, Dasse K A, Macris M P, Poirier V L, Cloy M J, Frazier O H
Cullen Cardiovascular Research Laboratories, Texas Heart Institute, Houston 77225-0345, USA.
ASAIO J. 1994 Jul-Sep;40(3):M471-5. doi: 10.1097/00002480-199407000-00044.
The vented electric Heartmate LVAD (VE-LVAD) (Thermo Cardiosystems, Inc., Woburn, MA) is a reliable, fully portable system that allows selected patients with end-stage cardiomyopathy to undergo outpatient treatment while waiting for heart transplantation. This implantable, pusher-plate LVAD is actuated by an electric motor located within the pump housing. The patient wears external batteries and a system controller, which power and control the LVAD motor through a percutaneous lead. Since May 1991, four men have been supported with the VE-LVAD. They ranged in age from 33 to 50 years (mean, 44.3 years); two had idiopathic cardiomyopathy, and two had ischemic cardiomyopathy. Of the four patients, three underwent support of 196, 219, and 504 days; support in the fourth patient is ongoing at more than 90 days. All four patients were fully rehabilitated to New York Heart Association Class I status. Because they were well and fully mobile, the protocol was amended to allow these patients to leave the hospital in a four phase program that begins with 16 hr day passes and leads to hospital discharge. When patients leave the hospital, they are accompanied by trained family members or friends. The patients who have participated in the program have performed routine activities, attended social events, and spent the night at home. The VE-LVAD system seems safe and appropriate for the outpatient setting in selected patients. Patients have been able to manage the system without assistance from medical or engineering personnel. This initial positive experience with outpatient LVAD treatment demonstrates the potential for providing long-term cardiac support with this type of implantable technology.
带排气孔的电动Heartmate左心室辅助装置（VE-LVAD）（美国马萨诸塞州沃本市的热控心血管系统公司）是一种可靠的、完全便携的系统，它使选定的终末期心肌病患者在等待心脏移植期间能够接受门诊治疗。这种可植入的推板型左心室辅助装置由位于泵壳内的电动马达驱动。患者佩戴外部电池和系统控制器，它们通过经皮导线为左心室辅助装置的马达供电并进行控制。自1991年5月以来，已有4名男性接受了VE-LVAD的支持。他们的年龄在33岁至50岁之间（平均44.3岁）；2人患有特发性心肌病，2人患有缺血性心肌病。4名患者中，有3名分别接受了196天、219天和504天的支持；第四名患者的支持时间已超过90天且仍在继续。所有4名患者均完全康复至纽约心脏协会I级状态。由于他们身体状况良好且行动自如，方案进行了修订，允许这些患者以一个分四个阶段的程序出院，该程序从每天16小时的日间外出开始，最终实现出院。患者出院时，由经过培训的家庭成员或朋友陪同。参与该项目的患者进行了日常活动、参加了社交活动并在家中过夜。VE-LVAD系统对于选定的患者在门诊环境中似乎是安全且合适的。患者能够在无需医疗或工程人员协助的情况下管理该系统。这种门诊左心室辅助装置治疗的初步积极经验证明了使用这种可植入技术提供长期心脏支持的潜力。
