Abstract:

This study summarizes the preoperative and intraoperative nursing experience in 5 cases of bridge-to-transplant heart transplantation with left ventricular assist device（LVAD） explant. Key points of nursing include：preoperative care and assessment of LVAD patients，preoperative discussion of the multidisciplinary team，safe transfer of patients to surgical rooms and other preoperative preparation，cardiomyocardial protection and multidisciplinary team cooperation during bridging transplantation，and intra-operative patient safety management. All 5 patients in this group successfully completed the surgery and were discharged. Pressure sores，wound infections，and other postoperative complications have not occurred. Postoperative cardiac function of 5 patients in this group were classified as New York Heart Association class Ⅰ~Ⅱ. The follow-up period for the 5 patients in this group ranged from 6 months to 6 years. The results of the most recent echocardiography follow-up showed that the left ventricular ejection fraction of all patients was all above 65%，with well prognosis.

Key words: Left Ventricular Assist Device, Heart Transplantation, Infection Control, Perioperative Nursing

摘要：

总结5例左心室辅助装置撤除桥接心脏移植手术的术前及术中护理经验。护理要点：术前对左心室辅助装置患者的护理及评估、多学科团队术前讨论制订手术方案、患者安全转运至手术间及其他术前准备、供心心肌保护及桥接移植术中多学科团队配合、术中患者安全管理。5例患者均顺利完成手术出院，无压力性损伤、伤口感染等术后并发症，术后按纽约心脏协会心力衰竭严重程度通用分级方法评估患者，心功能分级均达到Ⅰ~Ⅱ级，随访6个月— 6年，最近一次随访心脏超声结果显示左心室射血分数均在65%以上，患者预后良好。

关键词: 左心室辅助装置, 心脏移植, 感染控制, 围手术期护理