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Ann Thorac Surg 1976;21:456-457
© 1976 The Society of Thoracic Surgeons

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Articles

A New Approach to Left Heart Decompression

From the Division of Cardiovascular and Thoracic Surgery, University Hospital, and the University of Western Ontario, London, Ont, Canada.

Accepted for publication September 3, 1975.

^* Address reprint requests to Dr. Heimbecker, University Hospital, London, Ont, Canada.

A simple, safe, indirect technique for decompression of the left heart is described. Pulmonary artery venting produces immediate and total decompression of the left heart through spontaneous retrograde pulmonary flow across the open mitral valve in the hypothermic (29°C) electrically fibrillated heart. This allows free retrograde flow of left heart blood across the pulmonary valve into the right ventricle, where it is taken up by the usual caval cannulas.

In 25 of 66 consecutive patients undergoing elective ventricular fibrillation and anoxic arrest, left heart venting was necessary as indicated by rising left heart pressures. Total cardiac decompression was immediately and completely achieved by this simple indirect technique. Direct left heart venting, with its associated risks and disadvantages, was never necessary, and we now consider it obsolete.

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