心室辅助装置治疗心力衰竭——现状和下一步思考

Ventricular Assist Devices for the Treatment of Heart Failure:Current State and Future Prospects

心室辅助装置是终末期心力衰竭的重要有效治疗手段,我国在心室辅助装置应用领域起步较晚,但发展迅速。截至2023年3月,全国已经有70家医院共完成363例植入式心室辅助装置的应用,4款植入式心室辅助装置获得国家药品监督管理局批准上市。中国医学科学院阜外医院单中心随访结果显示,心室辅助装置植入术后1年生存率为94.7%,2年生存率为92.0%,3年生存率为90.7%,生存率优于国际同类产品,已经接近国内心脏移植治疗效果。为推进我国心室辅助技术规范化、高质量发展,一方面要建立全国范围内的心室辅助技术质控体系,严把质控关口;另一方面要成立心室辅助技术培训基地,做好心室辅助技术团队的规范化培训;建立中国机械循环支持注册登记研究,强化长期随访、管理及对术后并发症监测。

Ventricular Assist Devices(VADs)are an important and effective treatment method for end-stage heart failure.In China,the application of VADs started relatively late but developed rapidly in recent years.Up to March 2023,70 hospitals across the country have completed the application of 363 VADs,and three VADs have been approved by National Medical Products Administration.The single center follow-up results of Fuwai Hospital of the Chinese Academy of Medical Sciences showed that the 1-year survival rate,2-year survival rate,and 3-year survival rate after the implantation of VADs was 94.7%,92.0%,and 90.7%,respectively.The survival rates are superior to similar international products and are close to the survival rates of heart transplantation.To promote the standardization and high-quality development of VAD in China,it is necessary to establish a nationwide quality control system for VAD and strictly control the quality of VAD.In addition,training bases for VAD should be established to provide standardized training for the VAD team.The establishment of China registry for Mechanically Assisted Circulatory Support is also of importance.At the same time,it is necessary to strengthen the long-term follow-up management and closely monitor postoperative complications related to VAD implantation.