The development of cardiopulmonary bypass (CPB) to support the systemic circulation during cardiac surgical procedures became a clinical reality in 1953. Although the use of CPB for the treatment of post-infarction cardiogenic shock met with little success, intra-aortic balloon counterpulsation was used successfully in 1968 to reduce ischaemic injury in a patient with cardiogenic shock. Today, a broad spectrum of circulatory assist devices for short- and long-term application is available. Three major indication groups for the use of support devices are established. In low-cardiac-output syndrome after cardiac surgical procedures, short-term devices are utilised to enable myocardial recovery. In transplantation candidates suffering from drug-resistant pump failure, the implantation of long-term devices as a bridge to heart transplantation is indicated, and in NYHA class IV patients with contraindications to heart transplantation, the implantation of long-term devices as an alternative to transplantation is under discussion. In the literature, post-cardiotomy support survival is less than 30% on average. About 70% of mechanically bridged patients have survived to undergo heart transplantation and were transplanted with over 90% survival. Major problems during mechanical support are infection, bleeding, and thromboembolism. In view of patients' natural course without support, these clinical results are favourable.

译文

体外循环 (CPB) 的发展以支持心脏外科手术过程中的全身循环成为临床现实1953年。尽管使用CPB治疗梗塞后心源休克收效甚微,但主动脉内球囊反搏1968年成功用于减少心源休克患者的缺血性损伤。如今,可以使用广泛的短期和长期应用循环辅助设备。建立了使用支持设备的三个主要指示组。在心脏外科手术后的低心输出量综合征中,使用短期设备来恢复心肌。在患有抗药性泵衰竭的移植候选者中,建议植入长期装置作为心脏移植的桥梁,而在NYHA IV级有心脏移植禁忌症的患者中,植入长期装置作为替代移植正在讨论中。在文献中,心脏切开术后支持生存率平均低于30%。大约70% 的机械桥接的患者存活下来接受心脏移植,并以超过90% 的存活率移植。机械支持期间的主要问题是感染,出血和血栓栓塞。鉴于患者的自然病程没有支持,这些临床结果是有利的。

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