ABSTRACT
From January, 1982, to October, 1986, 33 patients were treated with either the Pierce-Donachy prosthetic ventricle or the Bio-Medicus ventricular assist device for cardiogenic shock following a cardiac operation, myocardial infarction, or cardiac transplantation. Twenty-five patients required the assistance for postcardiotomy shock and 8, for a variety of conditions including myocardial infarction shock and myocarditis, and as a bridge to cardiac transplantation. Complications were frequent and usually secondary to prolonged cardiopulmonary bypass. Results were poorest in the group with postcardiotomy shock. Earlier application of an assist device could lead to more frequent survival and avoidance of the detrimental effects of prolonged extracorporeal circulation.
Subject(s)
Assisted Circulation , Heart-Assist Devices , Shock, Cardiogenic/therapy , Acute Disease , Adult , Aged , Aged, 80 and over , Cardiac Surgical Procedures , Heart Transplantation , Humans , Male , Middle Aged , Myocardial Infarction/complications , Myocarditis/complications , Shock, Cardiogenic/etiology , Shock, Cardiogenic/mortalityABSTRACT
From September 1983 to March 1985, five patients who could not be weaned from extracorporeal circulation or who deteriorated in the recovery room have been treated with biventricular mechanical support using two vortex pumps, standard cannulas and tubing. One patient was supported for six hours following heart transplantation and acute graft failure until another donor heart could be found. Intraaortic balloon pumping was utilized in each patient to augment the circulation and produce pulsatile flow. Four of the five patients were weaned from the device. Only one patient is currently a long-term survivor. Although long-term survival has been low, the ability of the myocardium to recover was impressive and warrants the efforts at assisting the heart in biventricular failure.
