Implanted Heart Assist Device after Intracardiac Surgery

Litwak, Robert S.; Koffsky, Robert M.; Lukban, Salvador B.; Jurado, Roy A.; Elster, Samuel K.; Lajam, Fouad; Brancato, Russell W.

doi:10.1056/nejm197412192912508

Cited by 15 publications

(2 citation statements)

References 7 publications

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“…Under these conditions, it would be logical to propose that mechanical left heart support (even partial LIIB) could maintain circulatory stability while providing time for the injured myocardial cells to recover their functional capability. We anticipated that the increased pumping capability of the heart would be accompanied by a rise in MVO2 [5][6][7], a reflection of an improved metabolic state within the cells. The important canine experimental work of Wakabayashi and associates [8] provided strong support for this view.…”

Section: An Alternative Hypothesismentioning

confidence: 99%

A decade of experience with a left heart assist device in patients undergoing open intracardiac operation

et al. 1985

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Over a decade has elapsed since the first clinical application of our left heart assist device (LHAD). The basic concepts underlying its development evolved from prior experience in which, given adequate support time, less than total left heart bypass (LHB) was found to result in gradual improvement of depressed left ventricular function. Hence, the long‐held view that functional recovery of the heart could occuronlyunder conditions of total LHB seemed unsupportable by clinical realities. As a result, a simple LHAD was devised. Requiring only special silicone elastomer cannulas, the system uses a roller (or other continuous flow) pump and diverts blood from the left atrium to the ascending aorta. We believe a major asset of the system is the ability to separate the patient subsequently from the LHAD without need to re‐enter the thorax. This is accomplished by permanently occluding each cannula lumen with an obturator, thereby allowing the biocompatible cannulas to remain permanentlyin situ.To date, 27 patients have undergone LHAD support. Of 18 patients who could be separated from the device, half (9) were discharged from the hospital. Seven remain alive and well, the longest now more than 10 years after the operation. Although rarely needed, broadening operative indications in patients with severely compromised left ventricular function suggests that there will be continued need for a method of LHB for the foreseeable future.

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Section: An Alternative Hypothesismentioning

confidence: 99%

A decade of experience with a left heart assist device in patients undergoing open intracardiac operation

et al. 1985

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“…In 1961 Dennis (Dennis et al, 1962) demonstrated the left heart bypass by inserting an inflow carinula into the left atrium through the atrial septum and returning blood through the femoral artery. This principle was varied: Peters made cannulations to unload the left ventricle via apex (Peters et al, 1977), Zwart through the aortic valves (Zwart, 1966), and Litwak through the left atrium (Litwak, 1974). In addition, cardiac assistance can be performed with counterpulsation.…”

Section: Historical Backgroundmentioning

confidence: 99%