左心室辅助装置植入同期干预主动脉瓣反流的现状与研究进展  

Current status and research progress of left ventricular assist device implantation with concomitant intervention of aortic regurgitation

作　　者：王志华[1] 胡俊龙[1] 程兆云[1] WANG Zhihua;HU Junlong;CHENG Zhaoyun(Department of Cardiac Surgery,Central China Fuwai Hospital of Zhengzhou University,Zhengzhou,451464,China)

机构地区：[1]郑州大学华中阜外医院心外科,郑州451464

出　　处：《临床心血管病杂志》2024年第8期623-627,共5页Journal of Clinical Cardiology

基　　金：河南省重点研发专项(No:221111310300);河南省医学科技攻关计划项目(No:LHGJ20220111、SBGJ202101005)。

摘　　要：主动脉瓣反流(aortic regurgitation,AR)是终末期心力衰竭(心衰)患者接受左心室辅助装置(left ventricular assist device,LVAD)植入前评估和植入后管理的重要考虑因素。AR可在LVAD植入前即存在,也可在LVAD支持期间出现。AR通常是一种进行性疾病,可导致LVAD疗效降低和再发心衰症状。越来越多的研究显示,严重的AR会导致LVAD患者的血流动力学恶化、再入院率和死亡率增加。本文就接受LVAD植入的终末期心衰患者合并AR的发生率、病理生理学、危险因素、手术时机及方式、手术预后及指南、术后预防及管理的现状与研究进展进行综述。Aortic regurgitation(AR)is an important consideration in the pre-implantation evaluation and post-implantation management of patients with end-stage heart failure undergoing left ventricular assist device(LVAD).AR can be pre-existing prior to LVAD implantation or present during LVAD support.AR is usually a progressive disease that can lead to reduced LVAD efficacy and recurrent heart failure symptoms.A growing number of studies have shown that significant AR leads to hemodynamic deterioration,increased readmission rates and mortality in patients with LVAD.This review updated the progress in the incidence,pathophysiology,risk factors,timing and method of surgery,surgical prognosis and guidelines,and postoperative prevention and management of comorbid AR in patients with end-stage heart failure who underwent LVAD implantation.

关 键 词：心力衰竭 左心室辅助装置 主动脉瓣反流 手术干预 

分 类 号：R541.6[医药卫生—心血管疾病]