Recommendations for the Use of Mechanical Circulatory Support: Device Strategies and Patient Selection A Scientific Statement From the American Heart Association
Recommendations for the Use of Mechanical Circulatory Support: Device Strategies and Patient Selection A Scientific Statement From the American Heart Association
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DOI：
10.1161/cir.0b013e3182769a54
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发表时间：
2012-11-27
期刊：
影响因子：
37.8
通讯作者：
Toole, J. Matthew
中科院分区：
文献类型：
--
作者：
Peura, Jennifer L.;Colvin-Adams, Monica;Toole, J. Matthew
机械循环支持（MCS）的时代始于1953年，随着心肺转流术的发展，以促进心脏直视手术。1964年，美国国家心脏研究所（现在的国家心脏、肺和血液研究所）资助了人工心脏计划，并积极参与MCS的开发。这导致了1977年和1980年发布的提案请求，为20世纪90年代开发长期使用的植入式MCS奠定了基础，包括能够出院的器械。虽然心脏移植现在在许多医院很常见，但供体心脏供应不足和患者对移植的禁忌症继续严重限制其应用。随着患病心脏长期置换需求的增加，显然需要创新、安全和耐用的MCS来治疗不断增长的晚期心力衰竭（HF）患者。在过去的几年里，MCS领域发生了许多令人兴奋的变化，包括小型便携式泵的开发和目的地治疗（DT）的概念，或永久性泵放置作为心脏移植的替代方案。目前，没有公布使用监控监的准则。因此，我们的目的是本声明将为当代心脏病专家和其他HF提供者提供在确定MCS适当性时的一般考虑因素的理解。
The era of mechanical circulatory support (MCS) began in 1953 with the development of cardiopulmonary bypass to facilitate open heart surgery. 1 In 1964, the National Heart Institute (now the National Heart, Lung, and Blood Institute) funded the Artificial Heart Program and became actively involved in MCS development. This led to requests for Proposals issued in 1977 and 1980, which laid the foundation for the development of implantable MCS for long-term use, including devices capable of hospital discharge, in the 1990s. Although heart transplantation is now commonplace at many hospitals, the inadequate supply of donor hearts and patient contraindications to transplantation continue to severely restrict its application. As the demand for long-term replacement of diseased hearts increases, there is a clear need for innovative, safe, and durable MCS to treat the growing population of patients with advanced heart failure (HF). Many exciting changes in the field of MCS have occurred in the past few years, including the development of smaller portable pumps and the concept of destination therapy (DT), or permanent pump placement as an alternative to heart transplantation. Currently, there are no published guidelines for the use of MCS. Thus, it is our intent that this statement will provide the contemporary cardiologist and other HF providers with an understanding of general considerations when determining the appropriateness of MCS.