Use of a Left Heart Assist Device after Intracardiac Surgery: Technique and Clinical Experience

Litwak, Robert S.; Koffsky, Robert M.; Jurado, Roy A.; Lukban, Salvador B.; Ortiz, Arcadio F.; Fischer, A.; Sherman, James; Silvay, George; Lajam, Fouad

doi:10.1016/s0003-4975(10)64291-9

Cited by 75 publications

(18 citation statements)

References 22 publications

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“…Friiher wurde die extracorporale Kreislaufassistenz beim Postkardiomie low output Syndrom in Erg~inzung zur intraaortalen Gegenpulsation nur von wenigen spezialisierten kar-diochirurgischen Zentren mit maBigem Erfolg eingesetzt [1,5,6]. Hierzu wurde in der Regel ein Rollerpumpensystem am heparinisierten Patienten eingesetzt.…”

Section: Diskussionunclassified

“…Hierzu wurde in der Regel ein Rollerpumpensystem am heparinisierten Patienten eingesetzt. Bei den yon uns geschilderten drei Kasuistiken konnten FluBwerte bis zu 6 Die Erkenntnisse der postoperativen ventricularen Assistenz k6nnen nun auch auf Patienten im kardiogenen Schock nach Myokardinfarkt zur Infarktgr6Benreduktion bzw. W~ihrend jede Form der pneumatischen Kreislaufhilfen teuer und komplex in ihrer Handhabung sind, wiegen der geringere Anschaffungspreis, die geringe Bluttraumatisierung, die leichte Handhabung und der Verzicht auf Anticoagulation den Nachteil einer geringeren Effizienz der Zentrifugalpumpen auf.…”

Section: Diskussionunclassified

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114. Erfolgreiche post-Bypass extracorporale Kreislaufassistenz mit Zentrifugalpumpe

Jakob

Maass

Palzer

et al. 1987

Langenbecks Arch Chiv

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Patients with reduced left ventricular function do have an increased risk of inability to be weaned off bypass after open heart surgery despite maximal pharmacologic support and intraaortic balloon counter-pulsation. Centrifugal pumps used for extracorporeal circulatory assist can maintain a patient in low cardiac output up to days without anticoagulation. We used a centrifugal pump in 3 patients: as a left ventricular assist device (LVAD) in 2 patients and right ventricular assist device (RVAD) in 1 patient. One LVAD-patient became a long-term survivor after 20 h of assist, another was bridged successfully to an open heart procedure for 2 h after papillary muscle rupture. One RVAD patient died on the operating table due to massive tracheal bleeding probably caused by pulmonary hypertension.

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Section: Diskussionunclassified

114. Erfolgreiche post-Bypass extracorporale Kreislaufassistenz mit Zentrifugalpumpe

Jakob

Maass

Palzer

et al. 1987

Langenbecks Arch Chiv

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“…It is not the purpose of this communication to discuss this procedure; however, it can be stated that the early mortality of less than 5% is achieved in patients with suitable indications" 31 ; that the procedure improves left ventricular function, decreases filling pressure and increases patients work capacity; there is no definite proof that it also increases patients' survival, due to the lack of truly randomized studies.…”

Section: Surgical Treatment Of Chronic Heart Failurementioning

confidence: 99%

Surgical and mechanical support of the failing heart

Turina

1983

European Heart Journal

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“…However, significant diastolic augmentation was noted only in the former. LA-AO LHB, which has a sufficient supporting effect and does not damage the ventricular wall, was considered to be very useful for temporary support for the failing heart, especially for postoperative low output state.left ventricular assistance; TTI; DPTI; MVO2; coronary blood flow Left heart bypass, a method of mechanical assistance for severe left heart failure, has been utilized clinically (DeBakey 1971;Litwak et al 1976;Norman 1977; Pierce et al 1978) and some have reported satisfactory results (DeBakey 1971;Litwak et al 1976). Several methods of left heart bypass have been developed and they are divided into two main groups by the sites of blood drainage, that is, the left atrium to aorta bypass group (LA-AO LHB) and the left ventricle to aorta bypass group (LV-AO LHB).…”

mentioning

confidence: 99%

Evaluation of mechanical left ventricular assistance with left atrium to aorta bypass in dogs.

Sato

Kagawa

Nitta

et al. 1981

Tohoku J. Exp. Med.

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Effects of the left heart bypass (LHB) by the left atrium (LA) to the aorta (AO) shunt on the heart were evaluated by measuring such parameters as tension time index (TTI), diastolic pressure time index (DPTI), DPTI/TTI ratio, coronary blood flow and myocardial oxygen consumption (MVO2) in open-chest dogs. A pneumatically driven bypass pump made of polyurethane was utilized in this study. No significant change of MV02 was observed with surgical maneuver to connect the LA-AO LHB pump to experimental animals. During synchronous pumping of LHB, TTI decreased by 35%, MVO2 decreased by 56% of the control and DPTI/TTI ratio increased by 79%. However, coronary flow decreased by 35%, presumably due to autoregulation mechanism of the coronary circulatory system. Both synchronous and asynchronous LHB demonstrated the same level of effect in volume unloading. However, significant diastolic augmentation was noted only in the former. LA-AO LHB, which has a sufficient supporting effect and does not damage the ventricular wall, was considered to be very useful for temporary support for the failing heart, especially for postoperative low output state.left ventricular assistance; TTI; DPTI; MVO2; coronary blood flow Left heart bypass, a method of mechanical assistance for severe left heart failure, has been utilized clinically (DeBakey 1971;Litwak et al. 1976;Norman 1977; Pierce et al. 1978) and some have reported satisfactory results (DeBakey 1971;Litwak et al. 1976). Several methods of left heart bypass have been developed and they are divided into two main groups by the sites of blood drainage, that is, the left atrium to aorta bypass group (LA-AO LHB) and the left ventricle to aorta bypass group (LV-AO LHB). LA-AO LHB appears not to suppress left ventricular function and synchronous pumping to the natural heart rhythm is not mandatory with this method. In experimental set up with a normal heart, however, LA-AO LHB occasionary fails to drive a sufficient blood volume for the bypass. Thus, skeptism was raised for the use of LA-AO LHB, and many investigators have experimented LV-AO LHB (Hughes et al. 1975;Watanabe et al. 1975; Pierce et al. 1978). It is obvious that the LV-AO LHB is able to replace most of the cardiac

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Use of a Left Heart Assist Device after Intracardiac Surgery: Technique and Clinical Experience

Cited by 75 publications

References 22 publications

114. Erfolgreiche post-Bypass extracorporale Kreislaufassistenz mit Zentrifugalpumpe

114. Erfolgreiche post-Bypass extracorporale Kreislaufassistenz mit Zentrifugalpumpe

Surgical and mechanical support of the failing heart

Evaluation of mechanical left ventricular assistance with left atrium to aorta bypass in dogs.

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