Abstract
A servocontrol system was developed to regulate a single roller pump left atrial-aortic (La-A) assist device. Responsiveness of the servomechanism to blood volume changes, myocardial damage, and mitral regurgitation was evaluated in 5 sheep and 6 dogs. Myocardial damage was induced by occlusion of coronary arteries, and the hemodynamic effects of La-A assistance were evaluated. While La-A assistance reduced left atrial pressures to low levels, the left ventricular end-diastolic pressure remained elevated in the severely damaged heart. La-A assistance was used in 3 patients. Two were weaned from cardiopulmonary bypass after failure of intraaortic balloon counterpulsation, and 1 is a long-term survivor. The third was supported for 48 hours after attempted repair of complex congenital heart disease. The servocontrol device added to the safety of prolonged La-A assistance. This mode of assistance should be considered when intraaortic balloon counterpulsation has failed.
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