[Patient selection for left ventricular assist device implantation. The main problems].

IF 0.3 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Terapevticheskii Arkhiv Pub Date : 2024-10-10 DOI:10.26442/00403660.2024.09.202851

O Y Narusov, J A Shahramanova, V A Amanatova, A V Sychev, Y F Osmolovskaya, K G Ganaev, A A Shiryaev, I A Merkulova, D V Pevzner, M I Makeev, M A Saidova, F N Paleev, R S Akchurin, S N Tereshchenko, S A Boytsov

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引用次数: 0

Abstract

Aim: To analyze the experience of Chazov National Medical Research Center of Cardiology in patient selection for left ventricular assist device (LVAD) implantation.

Materials and methods: 901 patients, whose documents were sent to Chazov National Medical Research Center of Cardiology from regional medical and prophylactic institutions, were screened as selection for LVAD implantation. Firstly, all patients underwent transthoracic echocardiography performed according to the extended protocol with a comprehensive assessment of the left and right ventricle size and function. Patients who underwent the screening procedure underwent further examination including both laboratory and instrumental diagnostic methods. In addition, the polyclinic database of patients diagnosed with chronic heart failure (CHF) and dilated cardiomyopathy was also analyzed.

Results: Among 901 screened patients 7.9% were suitable candidates for LVAD implantation and only 23 (2.6%) patients underwent surgery. Among those not eligible for surgery: 208 (29%) patients were not on optimal medical therapy, 15% of patients had indications for other surgical treatment of CHF, 12% of patients had severe right ventricular failure, 9.8% had severe comorbidities, 6.8% of patients refused surgery.

Conclusions: The main problems of selection for LVAD implantation were: low awareness of doctors about the introduction of new treatment methods, poor quality of transthoracic echocardiography, a large percentage of patients not receiving basic therapy for CHF, untimely referral of patients for other types of surgical treatment.

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[左心室辅助装置植入术的患者选择。主要问题]。

目的：分析查佐夫国立心脏病学医学研究中心在选择左心室辅助装置（LVAD）植入患者方面的经验。材料与方法：从地区医疗和预防机构向查佐夫国立心脏病学医学研究中心递交文件的 901 名患者被筛选为左心室辅助装置植入患者。首先，所有患者均按照扩展方案接受经胸超声心动图检查，全面评估左心室和右心室的大小和功能。接受筛查的患者还需接受进一步检查，包括实验室和仪器诊断方法。此外，还对诊断为慢性心力衰竭（CHF）和扩张型心肌病患者的综合医院数据库进行了分析：在 901 名经过筛查的患者中，有 7.9% 的患者适合植入 LVAD，只有 23 名（2.6%）患者接受了手术。在不符合手术条件的患者中，208 名患者（29%）没有接受最佳的药物治疗，15%的患者有其他手术治疗 CHF 的指征，12%的患者有严重的右心室衰竭，9.8%的患者有严重的合并症，6.8%的患者拒绝手术：选择 LVAD 植入术的主要问题是：医生对引进新治疗方法的认识不足、经胸超声心动图检查质量差、很大比例的患者未接受 CHF 基础治疗、患者未及时转诊接受其他类型的外科治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Terapevticheskii Arkhiv 医学-医学：内科

CiteScore

1.40

自引率

33.30%

发文量

171

审稿时长

3-8 weeks

期刊介绍： Терапевтический архив The journal was founded by the prominent Russian therapists M.P. Konchalovsky and G.F. Lang in 1923. Then its editors-in-chief were Professors V.N. Vinogradov and A.G. Gukasyan. Since 1972, E.I. Chazov, Academician of the Russian Academy of Sciences, has been heading the editorial board of the journal. Over 90 years, there have been more than 1000 issues where the authors and editorial staff have done their best for readers to keep abreast of current advances in medical science and practice and for physicians to master the advanced principles of recognition and treatment of a wide spectrum of visceral diseases. The papers published in the journal (editorials, original articles, lectures, reviews, etc.) cover both current scientific achievements and practical experience in diagnosing, treating, and preventing visceral diseases. The authors of publications are not only Russian, but also foreign scientists and physicians. All papers are peer-reviewed by highly qualified Russian specialists. The journal is published monthly. Traditionally, each issue has predominantly certain thematic areas covering individual therapy specializations. Every year, one of the issues is devoted to related problems in practical medicine (allergology and immunology, neurology and psychiatry, obstetrics, oncology, etc.). This all draws the attention of the reading public to the journal. The journal is indexed in RSCI (Russian Science Citation Index), PubMed/Medline, Index Medicus, Scopus/EMBASE, Web of Science Core Collection (Science Citation Index Expanded), Web of Science (Russian Science Citation Index - RSCI, Current Contents Connect, BIOSIS Previews), Google Scholar, Ulrich''s Periodicals Directory. The journal is included in the list of periodicals recommended by the Higher Attestation Committee for publishing the papers containing the basic materials of doctoral and candidate dissertations. By the decision of the Presidium of the Russian Academy of Medical Sciences, the “Therapevticheskiy Arkhiv” was awarded the Botkin medal. It was admitted to the European Association of Sciences Editors (EASE). The journal was honored with the Golden Press Fund decoration at the 13th International Press Professional Exhibition.