用HeartMate 3左心室辅助装置恢复心肌:一个可以实现的目标,需要更高的精度
Lusha W Liang1, Annamaria Ladanyi1, Peter J Kennel1
1From the Division of Cardiology, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York.
概括
很少有左心室辅助器 (LVAD) 患者停止支持,尽管有恢复潜力. 本视角探讨了通过结构化计划和共享决策来提高LVAD戒断率的挑战和策略.
科学领域:
- 心脏病学 心脏病学
- 机械循环支持 机械循环支持
背景情况:
- 心肌恢复发生在10-30%的左心室辅助器件 (LVAD) 患者中.
- 然而,LVAD支持停止率仍然很低 (1-2%),与临床试验数据相比 (高达47%).
- 大多数LVAD项目缺乏结构化的恢复协议,导致戒烟率较低.
研究的目的:
- 总结在识别LVAD戒断候选人的挑战.
- 审查断奶LVAD支的方法和停止手术的手术技术.
- 讨论为LVAD戒断提供共享决策.
主要方法:
- 对当前的医学和外科文献进行了透视性审查.
- 在LVAD戒断方面面临的挑战分析.
- 讨论患者选择,断奶方案,手术技术和共同决策.
主要成果:
- 心肌恢复潜力和实际停止使用LVAD之间存在显著的差距.
- 患有心肌恢复的患者之间的异质性使戒断协议复杂化.
- 目前的LVAD项目在候选人识别,断奶,手术技术和共享决策方面面临挑战.
结论:
- 需要有结构的计划和有针对性的协议来提高LVAD戒断率.
- 解决医疗,外科和患者提供者沟通挑战对于成功停止LVAD至关重要.
- 需要进一步的研究和标准化的方法来优化LVAD探索结果.
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