左心室辅助装置的临床疗效及应用进展

Clinical Efficacy and Application Progress of Left Ventricular Assist Devices

心脏移植是治疗终末期心力衰竭最有效的手段。人工心脏的出现缓解了心脏供体不足的问题,其中左心室辅助装置(left ventricular assist device,LVAD)与其他装置相比具有易操作、创伤小等优势,因此逐渐成为了主要的治疗选择方式,并用于移植前的过渡支持和终点治疗,且终点治疗近年呈上升趋势。LVAD植入后会对患病心脏进行反向重构,使心肌恢复到相对健康的状态,患者长期携带可提高生存率。但LVAD植入存在右心衰竭、感染、血液相容性不良事件等植入风险。本文从以下三个方面进行论述:①VAD和全人工心脏;②LVAD植入的有效性;③LVAD植入风险性。

Heart transplantation is the most effective method for treating end-stage heart failure.The emergence of artificial hearts has al-leviated the problem of insufficient cardiac donors,among which left ventricular assist device(LVAD)has advantages such as ease of op-eration and minimal trauma compared to other devices.It has gradually become the main treatment choice and is used for pre transplant transitional support and destination therapy and destination therapy has been on the rise in recent years.After LVAD implantation,the diseased heart undergoes reverse remodeling,and the myocardium returns to a relatively healthy state.Long term carrying of LVAD can improve the survival rate of patients.However,LVAD implantation carries implantation risks such as right heart failure,infection,and ad-verse blood compatibility events.This article discusses the following three aspects:①VAD and total artificial heart;②The effectiveness of LVAD implantation;③LVAD implantation risk.