心室辅助装置应用现状及进展

Current status and progress on the application of ventricular assist device

心脏移植是目前终末期心力衰竭最有效的治疗手段,但供者短缺问题日益严峻。近年来,快速发展的机械循环支持技术为终末期心力衰竭患者提供了多种治疗选择。心室辅助装置(VAD)作为一种重要的机械循环支持,根据辅助时长可分为持久VAD(dVAD)和临时VAD(tVAD),其中dVAD在桥接心脏移植、终点治疗、为临床决策争取时间方面展现了良好的应用价值。随着技术的进步和临床应用经验的积累,VAD朝着更具生物相容性、更轻量化、更仿生、更智能的方向发展。本文主要对VAD发展历程、国内外应用现状及笔者单位VAD整体应用情况进行综述,以期为促进我国VAD的临床应用提供参考。

At present,heart transplantation is the most effective treatment for end-stage heart failure.Nevertheless,the shortage of donors is becoming an increasingly severe challenge.In recent years,rapid development of mechanical circulatory support technologies has provided multiple therapeutic options for patients with end-stage heart failure.As an important mechanical circulatory support device,ventricular assist device(VAD)are divided into durable VAD(dVAD)and temporary VAD(tVAD)according to the duration of assistance.dVAD shows application potential in bridging heart transplantation,destination therapy and bridge to decision.With technological progress and experience accumulation in clinical application,VAD is evolving towards the direction of more biocompatible,lighter,more bionic and intelligent.In this article,the development of VAD,application status at home and abroad and the overall application of VAD in our hospital were reviewed,aiming to provide reference for promoting the clinical application of VAD in China.