机械循环支持作为高级心力衰竭和移植的基石
Marta Braga1,2, Ana Isabel Pinho1,2, Ulrich Jorde3
1Department of Cardiology, Unidade de Saúde Local São João, Porto, Portugal.
Frontiers in cardiovascular medicine
|November 10, 2025
概括
机械循环支持 (MCS) 设备改善了等待心脏移植的高级心力衰竭 (HF) 患者的结果. 持久的MCS提供了比临时的MCS更好的预后,用于桥梁到移植 (BTT).
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 移植医学 移植医学
背景情况:
- 末期心力衰竭 (HF) 管理依赖于对传统疗法无反应的符合条件的患者进行正管心脏移植.
- 机械循环支持 (MCS) 设备,包括持久 (dMCS) 和临时 (tMCS) 选项,对于将患者连接到移植 (BTT) 和目的地治疗至关重要.
- 晚期HF患者数量正在增加,需要创新的治疗策略和资源配置考虑.
研究的目的:
- 审查各种MCS设备的特征和临床影响.
- 评估不同MCS策略对患者结果的影响,特别是在心脏移植的背景下.
- 讨论MCS设备分配的当前趋势和技术进步的未来方向.
主要方法:
- 文献综述总结了关于MCS设备 (持久和临时) 的现有证据.
- 分析与不同MCS策略相关的临床实践影响和患者结果.
- 讨论分配系统趋势和新兴MCS技术的作用.
主要成果:
- 持久的MCS,以HeartMate 3为例,显著改善了心脏移植等候名单患者的预后,并且与BTT中的tMCS相比,产生了更好的心脏移植后结果.
- 最近的分配系统趋势优先考虑TMCS患者,以改善患病者的结果.
- 像Impella 5.5这样的新兴tMCS设备显示了BTT的有希望的早期结果,需要进行正在进行的研究才能确定确切的指示.
结论:
- 持久的MCS与心脏移植候选人的优异结果有关,而当它被用作BTT策略时,与临时的MCS相比.
- 优化MCS资源的分配需要进一步的研究,以平衡基于紧急性的模型与移植前和移植后的结果.
- 在MCS技术中持续创新,专注于植入方便,无线电源和生理支持,对于推进高级高频护理至关重要.
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