Experimental and clinical results with a simplified left heart assist device for treatment of profound left ventricular dysfunction.

Abstract

AbstractDuring the last few years patients with profound heart failure following cardiac surgery have been managed with increasing success with the use of a variety of left heart assist devices. Although some previous experimental studies suggested that cannulation of the left ventricle was superior to that of the left atrium, present studies demonstrate that left atrial cannulation can effectively unload the left ventricle, and significantly decrease left ventricular work. Since 1978, a roller pump type of left heart assist device with cannulation of the left atrium and ascending aorta has been employed in 46 patients with severe postoperative cardiac failure. Twenty‐one patients were successfully weaned from the device; 5 patients died within 90 days of removal of the device, and there were 2 other late deaths 4 months and 4 years postoperatively. There were 14 long‐term survivors (6 months to 54 months). Thirteen of these patients are New York Heart Association class I or II, and 1 patient is New York Heart Association class III. Thus, satisfactory early and late results can be attained with this system. However, it has been postulated that if more complete left heart bypass were utilized, more patients would ultimately survive.