左室辅助系统研究进展——心力衰竭终末阶段的机械支持

Advance in Left ventricular Assist Devices Cardiac Mechanical Support for End Stage of Heart Failure

终末期心力衰竭对药物治疗反应差,患者多需等待心脏移植,但供体不足是突出矛盾而导致高病死率。左室辅助系统是采用机械动力泵将左室血液直接泵入主动脉,增强了左室收缩能力,降低左室的充盈压而增加全身的血液循环,不仅使终末期心力衰竭患者病死率下降并有时间过渡到移植阶段,更能使部分心力衰竭患者生活质量得到明显改善而成为终期治疗手段,应用前景广泛且光明。现就左室辅助系统的工作原理、临床管理、试验研究、并发症处理及应用前景等做一综述。

The mortalitv of end stage heart failure is high, and heart transplantation remains the treatment of choice. However, the limited number of available donors restricts this option to a limited population. Consequently, the utilization of left ventrieular assist devices has emerged over the last decade, as either a bridge to heart transplantation or as destination therapy. In this article, we deserihe the commercially available left ventricular assist devices, their effects on cardiovascular physiology and clinical outcomes, review landmark clinical trials in the mechanical circulatory support field, and discuss the potential future application of this field in China.