终末期心力衰竭合并可逆性肺动脉高压患者心脏移植指征的探讨

Discussion on heart transplantation indications in patients with end-stage heart failure complicated with reversible pulmonary artery hypertension

  • 摘要: 心脏移植是挽救终末期心力衰竭患者生命并改善其生活质量的方法,但并非所有的终末期心力衰竭患者都适合心脏移植。肺动脉高压作为终末期心力衰竭的常见并发症,可能会增加心脏移植术后右心衰竭的发生率,其与心脏移植术后受者的早期和晚期死亡风险相关。在临床实践中,不同移植中心对终末期心力衰竭合并肺动脉高压患者心脏移植指征的评判标准不一。术前正确地评估手术指征是决定心脏移植能否成功的重要因素。本文综述了肺动脉高压的定义、病因及其对心脏移植的影响、诊断方法及其可逆性的判断,可逆性肺动脉高压的诊断性治疗及终末期心力衰竭合并可逆性肺动脉高压患者心脏移植指征。

     

    Abstract: Heart transplantation can save the life and improve the quality of life of patients with end-stage heart failure. Nevertheless, it is not suitable for all patients with end-stage heart failure. As a common complication of end-stage heart failure, pulmonary artery hypertension may increase the incidence of right heart failure after heart transplantation, which is associated with the short- and long-term fatality risk in the recipients after heart transplantation. In clinical practice, different transplant centers have different criteria for heart transplantation indications in patients with end-stage heart failure complicated with pulmonary artery hypertension. Accurate preoperative evaluation of surgical indications plays a critical role in determining the success of heart transplantation. In this article, the definition, pathogenesis and effects on heart transplantation, diagnostic methods and reversibility judgment of pulmonary artery hypertension, diagnostic treatment of reversible pulmonary artery hypertension and indications of heart transplantation in patients with end-stage heart failure complicated with reversible pulmonary hypertension were reviewed.

     

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