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The Annals of Thoracic Surgery, Vol 49, 299-304, Copyright © 1990 by The Society of Thoracic Surgeons
OH Frazier, RK Wampler, JM Duncan, WE Dear, MP Macris, SM Parnis and JM Fuqua
The Hemopump, a catheter-mounted, temporary ventricular assist device,
consists of an external electromechanical drive console and a disposable,
intraarterial axial-flow pump (21F). Power is transmitted percutaneously to
the pump by a flexible drive shaft within the catheter. The device is
positioned in the left ventricle by way of the femoral artery approach or
through the ascending aorta. Blood is drawn from the left ventricle through
the transvalvular inlet cannula and pumped into the aorta. As of December
1988, the Hemopump had successfully supported the circulation of 7 patients
(5 men, 2 women) ranging in age from 44 to 72 years (mean age, 59 years)
and suffering from cardiogenic shock (cardiac index less than 2.0
L/min/m2). Indications for use included failure to be weaned from
cardiopulmonary bypass in 4 patients, acute myocardial infarction in 1,
severe cardiac allograft rejection in 1, and donor heart failure in 1.
Duration of support ranged from 26 to 113 hours (mean, 66 hours). Although
5 patients demonstrated transient hemolysis, none experienced infection,
thrombosis, or vascular injury. Hemodynamic variables improved in all
patients during support by the device. As of December 1988, 5 of the 7
patients were alive more than 30 days after support had been discontinued,
and 3 of these patients were discharged from the hospital. On the basis of
our initial clinical results, the Hemopump, which does not require a major
surgical procedure for insertion, provides effective, temporary circulatory
support in patients with potentially reversible cardiac failure.
ARTICLES
First human use of the Hemopump, a catheter-mounted ventricular assist device
Cullen Cardiovascular Surgical Research Laboratories, Texas Heart Institute/St. Luke's Episcopal Hospital, Houston 77225.
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