是时候停止生活在一个HeartMate II的世界吗?
Melana Yuzefpolskaya1, Amy G Fiedler2, Jason N Katz3
1Division of Cardiovascular Medicine, Columbia University Irving Medical Center, New York, New York.
概括
尽管技术取得了进步,但用于高级心力衰竭 (HF) 的左心室辅助装置 (LVAD) 的使用却有所减少. 这一趋势需要重新评估候选人,决策和管理策略,以改善患者护理.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 心脏衰竭管理的管理
背景情况:
- 现代左心室辅助装置 (LVAD) 技术显示改善了患者的治疗结果.
- 尽管有技术进步,但近年来对末期心力衰竭 (HF) 的LVAD使用量有所下降.
研究的目的:
- 为了检查使用LVAD的下降趋势.
- 确定在高级心力衰竭 (HF) 管理方面需要改进的领域.
- 为该领域提出关于LVAD治疗的行动呼吁.
主要方法:
- 对LVAD使用趋势的分析.
- 对LVAD候选人的当前评估参数进行批判性审查.
- 对LVAD与心脏移植的决策过程的检查.
- 对高级HF患者的当代管理范式的评估.
主要成果:
- 尽管设备效果有所改善,但LVAD使用量显著下降.
- 在改善技术和减少采用之间存在着固有的矛盾.
- 目前的候选人评估实践,LVAD与移植决策以及管理范式可能已经过时.
结论:
- 需要对LVAD候选人评估进行现代化.
- 修改对LVAD与移植决策的二分法方法至关重要.
- 更新管理范式对于与现代技术优势保持一致至关重要.
- 这些更新是为了优化对晚期心力衰竭患者的护理而需要的.
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