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A Servocontrolled Atrial-Aortic Assist Device: Experimental Findings and Clinical Experience

1976; Elsevier BV; Volume: 22; Issue: 6 Linguagem: Inglês

10.1016/s0003-4975(10)64473-6

1552-6259

Hillel Laks, Joseph D. Marco, Thomas L. Farmer, John W. Standeven, George C. Kaiser, Vallee L. Willman,

Cardiac Structural Anomalies and Repair

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 longterm 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. Cardiogenic shock after myocardial infarction or an open-heart operation may be unresponsive to intraaortic balloon counterpulsation (IABC) .To treat this group of patients, several devices have been developed to provide left ventricular assistance [l, 3, 6, 141.Left ventricular apicalaortic bypass with an assist pump has the advantage of decompressing the left ventricular cavity [l, 41.Zwart and his associates [161 reported on the use of transarterial closed-chest left ventricular bypass.Glassman and colleagues