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🌱 來自: Treatment of acute advanced heart failure

mechanical circulatory support

• Temporary: bridge to recovery, transplant, or durable MCS; periprocedural support

• Intra-aortic balloon pump (IABP): inflates in diastole & deflates in systole to ↓ impedance to LV ejection, ↓ myocardial O2 demand & ↑ coronary perfusion; +0.5 L/min CO

• Axial flow pumps (eg, Impella): Archimedes screw principle in LV; +3.7–5.5 L/min

• Extracorporeal centrifugal pumps: TandemHeart (+5 L/min, percutaneous) & CentriMag (10 L/min, surgical)

• Extracorporeal membrane oxygenation (ECMO): 6 L/min (JACC HF 2018;6:503)

• Durable: surgically placed LVAD ± RVAD as bridge to sufficient recovery (in 5–50% of niCMP; JACC 2017;69:1924), to transplant or as destination Rx (>50% ↓ 1-y mort. vs. med Rx; NEJM 2001;345:1435 & 2009;361:2241). Current preferred option is fully magnetically levitated centrifugal flow pump (HeartMate 3), ↓ stroke or re-op vs. axial flow models (NEJM 2019;380:1618).

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in end-stage HF; NEJM 2009;361:2241), or as a mechanical circulatory support (MCS) device

Mechanical circulatory support

• Temporary: bridge to recovery, transplant, or durable MCS; periprocedural support

• Intra-aortic balloon pump (IABP): inflates in diastole & deflates in systole to ↓ impedance to LV ejection, ↓ myocardial O2 demand & ↑ coronary perfusion; +0.5 L/min CO

• Axial flow pumps (eg, Impella): Archimedes screw principle in LV; +3.7–5.5 L/min

• Extracorporeal centrifugal pumps: TandemHeart (+5 L/min, percutaneous) & CentriMag (10 L/min, surgical)

• Extracorporeal membrane oxygenation (ECMO): 6 L/min (JACC HF 2018;6:503)

• Durable: surgically placed LVAD ± RVAD as bridge to sufficient recovery (in 5–50% of niCMP; JACC 2017;69:1924), to transplant or as destination Rx (in end-stage HF; NEJM 2009;361:2241), or as a mechanical circulatory support (MCS) device

窩的英文不太好

在晚期 HF 中； NEJM 2009;361:2241)，或作為機械循環支持 (MCS) 設備

機械循環支持

• 臨時：過渡到恢復、移植或持久的 MCS；圍手術期支持

• 主動脈內球囊泵 (IABP)：在舒張期充氣，在收縮期放氣，以降低 LV 射血阻抗、↓ 心肌 O2 需求和 ↑ 冠狀動脈灌注； +0.5 升/分鐘一氧化碳

• 軸流泵（例如 Impella）：LV 中的阿基米德螺旋原理； +3.7–5.5 升/分鐘

• 體外離心泵：TandemHeart（+5 L/min，經皮）和 CentriMag（10 L/min，手術）

• 體外膜肺氧合 (ECMO)：6 L/min (JACC HF 2018;6:503)

• 耐用：手術放置 LVAD ± RVAD 作為充分恢復的橋樑（在 5-50% 的 niCMP 中；JACC 2017；69:1924），用於移植或作為目的地 Rx（在終末期 HF；NEJM 2009；361:2241） ，或作為機械循環支持 (MCS) 設備