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Hillel Laks
Joseph D. Marco
George C. Kaiser
Vallee L. Willman
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Ann Thorac Surg 1976;22:546-556
© 1976 The Society of Thoracic Surgeons

Articles

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

Hillel Laks, M.D.*, Joseph D. Marco, M.D., Thomas L. Farmer, B.S., John W. Standeven, Ph.D., George C. Kaiser, M.D., Vallee L. Willman, M.D.

From the Department of Surgery, Saint Louis University School of Medicine, St Louis, MO

* Address reprint requests to Dr. Laks, Department of Surgery, Saint Louis University School of Medicine, 1325 S Grand Blvd, St Louis, MO 63104

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 long-term 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.




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[Abstract] [PDF]


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