Abstract
A percutaneous left ventricular assist system (PLVAS) using a modification of the Dennis method was developed and implemented in 8 patients. Transseptal cannulation was performed under biplane fluoroscopy and/or transesophageal echocardiogram without encountering any problems. All the patients were in a state of severe cardiogenic shock, caused by acute myocardial infarction in 5, cardiomyopathy in 2, and postcardiotomy in 1, and were on intraaortic balloon pump support and/or percutaneous cardiopulmonary support (PCPS), in the form of partial cardiopulmonary bypass. Three patients who developed concomitant right heart failure required additional PCPS. All the patients were supported at 3.0 to 4.0l/min for 76–284h for an average time of 159h. Three patients were successfully weaned from PLVAS and one of these patients, who had suffered an acute myocardial infarction, was discharged from hospital. The complications directly related to this system were minimal. Our observations led to the conclusion that PLVAS using our modification of the Dennis method is a simple, easy, and safe means of maintaining adequate systemic circulation in severely ill patients. As PLVAS is particularly effective for patients in cardiogenic shock following acute myocardial infarction, we believe that it will be applied routinely by many cardiac surgeons and cardiologists in the future.
Similar content being viewed by others
References
Pae WE, Miller CA, Mathews Y, Pierce WS (1992) Ventricular assist devices for postcardiotomy cardiogenic shock. J Thorac Cardiovasc Surg 104:541–553
Matsuda H, Matsuwaka R, Kaneko M, Kobayashi T, Miyamoto K, Morisaki H, Kawata H, Takami H, Masai T, Nakano S, Kawashima Y (1990) Analysis of clinical factors for survival after left and biventricular bypass using centrifugal pump following open heart surgery in infants and adults. Artif Organs 14:382–386
Golding LAR, Crouch RD, Stewart RW, Novoa R, Lytle BW, McCarthy PM, Taylor PC, Loop FD, Cosgrove DM (1992) Postcardiotomy centrifugal mechanical ventricular support. Ann Thorac Surg 54:1054–1064
Pennington DG, Swartz M, Codd JE, Merjavy JP, Kaiser GC (1983) Intraaortic balloon pumping in cardiac surgical patients: a nine-year experience. Ann Thorac Surg 36:125–131
Phillips SJ, Ballenitine B, Slonine D, Hall J, Vandehaar J, Kongtahworn C, Zeff RH, Skinner JR, Reckmo K, Gray D (1983) Percutaneous initiation of cardiopulmonary bypass. Ann Thorac Surg 36:223–225
Barvarian JE, Ratciff MB, Gupta KB, Wenger RK, Bogen DK, Edmunds H (1988) Changes in left ventricular wall stress during biventricular circulatory assistance. Ann Thorac Surg 45:526–532
Dennis C, Hall DP, Moreno JR, Senning A (1962) Left atrial cannulation without thoractomy for total left heart bypass. Acta Chir Scand 123:267–279
Glassman E, Engelman RM, Boyd AD, Lipson D, Ackerman B, Spencer FC (1975) A method of closed-chest cannulation of the left atrium-femoral artery bypass. J Thorac Cardiovasc Surg 69:283–290
Downing WS, Llaneras M, Georgi D, Dennis CW, Savage EB, Edmunds LH (1992) Left ventricular assistance without thoracotomy: mediastinal and transseptal approaches to the left heart. Ann Thorac Surg 53:132–138
Satoh H, Kobayashi T, Nakano S, Shimazaki Y, Kaneko M, Matsuda H (1993) Clinical application of percutaneous left ventricular support with a centrifugal pump. ASAIO Trans 39:153–155
Satoh H, Kobayashi T, Nakano S, Shimazaki Y, Kaneko M, Miyamoto Y, Takahashi T, Matsuda H (1993) Clinical experience with percutaneous left ventricular support using transseptal left atrial-femoral artery by pass. In: Akutsu T, Koyanagi H (eds) Artificial Heart IV. Springer, Berlin Heidelberg New York Tokyo, pp 213–215
Miyamoto Y, Nakano S, Kaneko M, Matsuwaka R, Satoh H, Matsuda H (1993) Analysis of complications affecting survival after employment of ventricular assist system (VAS) using pneumatic and centrifugal pumps. In: Akutsu T, Koyanagi H (eds) Artificial Heart IV. Springer, Berlin Heidelberg New York Tokyo, pp 237–243
Yano M, Matsuo K, Hatane T, Araki K, Onitsuka T, Shibata K, Koga K (1993) The feasibility and efficacy of right ventricular assistance without thoractomy. ASAIO Trans 39:120–125
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Satoh, H., Kobayashi, T., Nakano, S. et al. Percutaneous left ventricular assist system using a modification of the Dennis method: Initial clinical evaluation and results. Surg Today 25, 883–890 (1995). https://doi.org/10.1007/BF00311753
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00311753