While biventricular assist devices(BiVADs)remain underutilized in Western countries for biventricular heart failure(BHF),their application is expanding in China.This consensus synthesizes international guidelines,medi...While biventricular assist devices(BiVADs)remain underutilized in Western countries for biventricular heart failure(BHF),their application is expanding in China.This consensus synthesizes international guidelines,medical evidence,and Chinese clinical expertise to establish standardized protocols for BiVAD management.Key recommendations include:(1)Preoperative right heart catheterization and echocardiography for central venous pressure(CVP):pulmonary capillary wedge pressure(PCWP)ratio and pulmonary artery pulsatility index(PAPi)assessment(Class I);(2)BiVAD indication in refractory BHF or high-risk right heart failure post-left ventricular assist device(LVAD)implantation(Class IIa);(3)Right atrial implantation as the preferred surgical approach(Class IIa);(4)Warfarin-based anticoagulation(INR 2.0–2.5)with aspirin,avoiding direct oral anticoagulants(DOACs)(Class III).The guidance addresses critical gaps in patient selection,pump speed titration,and complication management,positioning integrated BiVAD systems as a promising solution for complex BHF.展开更多
Temporary mechanical circulatory support(tMCS)plays a pivotal role in managing severe or refractory cardiogenic shock(CS),furnishing essential hemodynamic support,and sustaining organ perfusion from hours to weeks,or ...Temporary mechanical circulatory support(tMCS)plays a pivotal role in managing severe or refractory cardiogenic shock(CS),furnishing essential hemodynamic support,and sustaining organ perfusion from hours to weeks,or to even months.In the past decade,the utilization of tMCS has witnessed a signicant increase in American and European countries.Meanwhile in Asia,the newly developed concepts and devices constituting tMCS have also made rapid progress.Nevertheless,the absence of a consensus or standardized guidelines,especially for the Asian population considering inherited polymorphism,is evident.To address this knowledge gap,eight associations/societies and experts in thiseld came up with the present consensus after repeated discussions,more specically for the Asian population.It comprehensively elucidates the commonly employed tMCS devices,criteria for patient selection,indications and contraindications,clinical management,and the optimal timing for implantation and weaning.The goal of this statement is to promote the standardized application of tMCS and make reasonable decisions in clinical practice.Full-length version of the consensus can be seen in Supplementary File,http://links.lww.com/CM9/B883.展开更多
文摘While biventricular assist devices(BiVADs)remain underutilized in Western countries for biventricular heart failure(BHF),their application is expanding in China.This consensus synthesizes international guidelines,medical evidence,and Chinese clinical expertise to establish standardized protocols for BiVAD management.Key recommendations include:(1)Preoperative right heart catheterization and echocardiography for central venous pressure(CVP):pulmonary capillary wedge pressure(PCWP)ratio and pulmonary artery pulsatility index(PAPi)assessment(Class I);(2)BiVAD indication in refractory BHF or high-risk right heart failure post-left ventricular assist device(LVAD)implantation(Class IIa);(3)Right atrial implantation as the preferred surgical approach(Class IIa);(4)Warfarin-based anticoagulation(INR 2.0–2.5)with aspirin,avoiding direct oral anticoagulants(DOACs)(Class III).The guidance addresses critical gaps in patient selection,pump speed titration,and complication management,positioning integrated BiVAD systems as a promising solution for complex BHF.
基金National Natural Science Foundation of China(Nos.81974034,81970396,81670351,and 82001701)National Key Research and Development Program(No.2021YFA 1101900)
文摘Temporary mechanical circulatory support(tMCS)plays a pivotal role in managing severe or refractory cardiogenic shock(CS),furnishing essential hemodynamic support,and sustaining organ perfusion from hours to weeks,or to even months.In the past decade,the utilization of tMCS has witnessed a signicant increase in American and European countries.Meanwhile in Asia,the newly developed concepts and devices constituting tMCS have also made rapid progress.Nevertheless,the absence of a consensus or standardized guidelines,especially for the Asian population considering inherited polymorphism,is evident.To address this knowledge gap,eight associations/societies and experts in thiseld came up with the present consensus after repeated discussions,more specically for the Asian population.It comprehensively elucidates the commonly employed tMCS devices,criteria for patient selection,indications and contraindications,clinical management,and the optimal timing for implantation and weaning.The goal of this statement is to promote the standardized application of tMCS and make reasonable decisions in clinical practice.Full-length version of the consensus can be seen in Supplementary File,http://links.lww.com/CM9/B883.
