Obturated Permanent Left Atrial and Aortic Cannulae for Assisted Circulation After Cardiac Surgery

Litwak, Robert S.; Lajam, Fouad; Koffsky, Robert M.; Silvay, George; Shiang, Howard; Geller, Stephen A.; Pedersen, Finn Skou

doi:10.1097/00002480-197301900-00041

Cited by 11 publications

(2 citation statements)

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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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“…Parallel to the increasing cardiosurgical activities, research in this field was also intensified. This was due to operative stress on the heart and the influence of the heart-lung machine on circulation [22][23][24][25][26][27][28][29]. It was proven that, after cardiac surgery using extracorporeal circulation systems, about 10% of the patients were not immediately able to build up a sufficient heart-time-volume.…”

Section: Introductionmentioning

confidence: 99%