Joyce L D, Kiser J C, Eales F, King R M, Overton J W, Toninato C J
Minneapolis Heart Institute, Minnesota, USA.
Ann Thorac Surg. 1996 Jan;61(1):287-90; discussion 311-3. doi: 10.1016/0003-4975(95)01002-5.
The data presented are a brief summary of The International Registry for Mechanical Ventricular Assist Pumps and Artificial Hearts and a summary of the personal experience of the Minnesota Thoracic Associates at the Minneapolis Heart Institute with the use of the Sams centrifugal pump from May 1985 to September 1994.
Ventricular support with the use of centrifugal pumps for postcardiotomy shock consisted of cannulation of the left atrium and aorta for left ventricular support and the right atrium and pulmonary artery for right ventricular support, or the combination of the two for biventricular support.
The average survival and discharge rate recorded by the National Registry for postcardiotomy syndrome was 25.3%. Our experience at Minnesota Thoracic Associates was 54%. The National Registry reported 45.7% of the patients being weaned from the device or receiving transplants and 25.3% of the patients ultimately discharged from the hospital. Sixty-five percent of the patients in our experience either were weaned from the device or received a transplant for an overall discharge rate of 42%. The average effective hospital cost per survivor was almost $400,000.00.
It is our belief that when considering the cost analysis of temporary devices, one must conclude that a more economical approach for the treatment of end-stage cardiac disease would be aggressive development of a permanent ventricular assist device.
所呈现的数据是国际心室辅助泵和人工心脏注册中心的简要总结,以及明尼阿波利斯心脏研究所明尼苏达胸科协会在1985年5月至1994年9月使用Sams离心泵的个人经验总结。
使用离心泵对心脏术后休克进行心室支持,包括经左心房和主动脉插管进行左心室支持,经右心房和肺动脉插管进行右心室支持,或两者联合进行双心室支持。
国家注册中心记录的心脏术后综合征患者的平均生存率和出院率为25.3%。我们明尼苏达胸科协会的经验是54%。国家注册中心报告称,45.7%的患者撤机或接受了移植,25.3%的患者最终出院。在我们的经验中,65%的患者撤机或接受了移植,总体出院率为42%。每位幸存者的平均有效住院费用近40万美元。
我们认为,在考虑临时装置的成本分析时,必须得出这样的结论:对于终末期心脏病的治疗,一种更经济的方法是积极开发永久性心室辅助装置。