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Ann Thorac Surg 1989;47:124-129
© 1989 The Society of Thoracic Surgeons

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Articles

Technique and results with a roller pump left and right heart assist device

^a Departments of Thoracic and Cardiovascular Surgery, New York University Medical Center, New York U.S.A.
^b Departments of Thoracic and Cardiovascular Surgery, Maimonides Medical Center, Brooklyn U.S.A.
^c Departments of Thoracic and Cardiovascular Surgery, State University Hospital, Health Science Center at Brooklyn, Brooklyn, New York U.S.A.

^_* Address reprint requests to Dr Rose, Chief, Division of Cardiovascular Surgery, St. Vincent's Medical Center, 2800 Main St, Bridgeport, CT 06606.

During the last 10 years we have inserted a roller pumpdriven left heart assist device in 72 patients and a right heart assist device in 7 patients for profound heart failure after a variety of cardiac surgical procedures. In addition a percutaneous left heart assist device (transseptal insertion of left atrial cannula via a femoral vein) was employed in 5 patients with profound cardiogenic shock after acute myocardial infarction. Thirty patients (41.7%) were weaned from the left heart assist device and 21 (29.2%) were discharged from the hospital. Two patients (40.0%) were weaned from the right heart assist device, but both later died during the postoperative period. Of the 5 patients in whom a percutaneous left heart assist device was inserted, 4 underwent successful emergency percutaneous transluminal coronary angioplasty, but all 5 patients died. Causes of death included severe coagulopathy, irreversible extensive myocardial infarction and cardiac failure, refractory arrhythmias, severe "shock" lung, and multisystem failure. In summary, satisfactory results can be achieved with a roller pump-driven left and right heart assist device for severe postoperative heart failure. Further experience should be obtained with the percutaneous technique to assess its efficacy in treating patients with acute myocardial infarction and cardiogenic shock.

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