Evaluation for Heart Transplantation and LVAD Implantation JACC Council Perspectives
Evaluation for Heart Transplantation and LVAD Implantation JACC Council Perspectives
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DOI：
10.1016/j.jacc.2020.01.034
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发表时间：
2020-03-31
影响因子：
24
通讯作者：
Bozkurt, Biykem
中科院分区：
文献类型：
--
作者：
Guglin, Maya;Zucker, Mark J.;Bozkurt, Biykem
及时转诊移植和左心室辅助装置植入在晚期心力衰竭患者的良好结局中起着关键作用。尽管如此，评估通常发生在先进的心力衰竭中心，是模糊的转介医生。本综述的目的是解释先进治疗候选人的决策过程，并描述新的器官分配算法对中心决策的潜在影响。该文件首先讨论了晚期心力衰竭的体征，特别关注了低心输出量综合征作为晚期心力衰竭关键特征的重要性，然后将评价总结为3步过程，解决了以下问题：1）是否适合植入移植或耐用辅助装置？2)是否存在任何一种干预的禁忌症？3)如果有先进治疗的适应症而不是禁忌症，如何在移植和左心室辅助装置植入之间进行选择？(C)2020年由美国心脏病学会基金会。
Timely referrals for transplantation and left ventricular assist device implantation play a key rote in favorable outcomes in patients with advanced heart failure. Nonetheless, evaluation usually occurs at advanced heart failure centers and is obscured from referring physicians. The purposes of this review are to explain the decision-making process for candidacy for advanced therapies and to describe the potential impact of the new organ allocation algorithm on center derision making. The document first addresses the signs of advanced heart failure, specifically focusing on the importance of the syndrome of low cardiac output as a key feature of advanced heart failure, and then summarizes the evaluation as a 3-step process addressing the following questions: 1) Is transplantation or durable assist device placement indicated? 2) Are there contraindications to either intervention? 3) How can one choose between transplantation and left ventricular assist device implantation if advanced therapies are indicated and not contraindicated? (C) 2020 by the American College of Cardiology Foundation.