植入式左心室辅助装置的综合手术策略  

Integrated surgical strategy for implantation of left ventricular assist devices

作　　者：赵双雷 韩杰[1] 姜文剑[1] 张宏家[1] 贡鸣[1] Zhao Shuanglei;Han Jie;Jiang Wenjian;Zhang Hongjia;Gong Ming(Department of Cardiac Surgery,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院心脏外科,北京100029

出　　处：《中华胸心血管外科杂志》2024年第12期764-768,共5页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：国家自然科学基金(82370399);国家重点研发计划(2021YFC2501100);首都卫生发展科研专项项目(首发2022-2-1053)。

摘　　要：植入式左心室辅助装置作为辅助类人工器官,仅辅助心室工作,不能完全代替心脏。然而,需行左心室辅助装置置入术的终末期心力衰竭患者往往合并其他心脏结构病变,包括主动脉、主动脉瓣、二尖瓣、三尖瓣、冠状动脉的病变。因此,左心室辅助装置置入手术不仅是单纯的装置置入操作,还是需联合其他心脏大血管手术的综合手术。左心室辅助装置置入联合其他心脏大血管手术的指征和获益情况尚存争议,目前已有的回顾性研究并未得出一致性结论,且缺乏相应的归纳总结;国内也缺乏对该问题的系统认识。本文对植入式左心室辅助装置综合手术策略做一概述,并总结一些具体问题处理方法,以期为外科医师全面系统地认识该综合手术策略提供参考。As auxiliary artificial organ,left ventricular assist device(LVAD)can only assist the left ventricle of the human heart,but cannot completely replace the human heart.However,end-stage heart failure patients requiring LVAD implantation often suffer other anatomical comorbidities,including lesions of aorta,aortic valve,mitral valve,tricuspid valve,and coronary artery.Thus,in most cases,the implant alone is not enough and requires multiple additional cardiac and aortic procedures.However,the indications and benefits of LVAD implantation in combination with other cardiac and aortic procedures are still unclear.Previous retrospective studies have not reached consistent conclusions.There is a lack of systematic understanding of this issue in China.Therefore,we provide an overview of the integrated surgical strategy for implantation of LVAD,aiming to help clinicians have a comprehensive understanding of this issue and provide some guidance.

关 键 词：左心室辅助装置 手术策略 综合手术 回顾性研究 植入式 外科医师 主动脉瓣 人工器官 

分 类 号：R54[医药卫生—心血管疾病]