左心室辅助装置置入术后右心衰的预测因素、处理策略和装置应用

Right ventricular dysfunction in patients undergoing left ventricular assist devicelmplantation:predictors,management,and device utilization

目前,置入左心室辅助装置(left ventricular assist device,LVAD)已成为终末期心力衰竭治疗的重要手段,但LVAD术后右心衰(right ventricular heart-failure,RVF)发生率为5%~44%,而且患者需要右心室机械辅助时,死亡比例最高达50%。因此,如果术前能监测各项相关因素指标进行预测评估并及时干预以及加强围手术期管理,对降低右心室功能障碍、改善预后十分重要。本文对LVAD术后发生RVF的预测因素、处理策略及装置的应用进行综述。

Left ventricular assist device(LVAD)has become an important means in the treatment of end-stage heart failure.The incidence of RVF in LVAD recipientsis as high as 10%to 40%,and the mortality rate is as high as 50%.Therefore,it is important to reduce right ventricular dysfunction and improve prognosis if all relevant factors can be monitored and evaluated before operation and timely intervention and perioperative management can be strengthened.This article will review the predictive factors,management strategies and application of devices for RVF after LVAD operation.