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The Annals of Thoracic Surgery, Vol 55, 250-256, Copyright © 1993 by The Society of Thoracic Surgeons
H Takano, T Nakatani and Y Taenaka
In Japan, five types of ventricular assist system, including the
government-approved National Cardiovascular Center type and the Tokyo
University type, were applied to 202 patients as of September 30, 1991.
Adult-sized ventricular assist systems were used in 194 patients and a
pediatric one in 8. The major primary diagnosis was ischemic heart disease
(52.5%). Sixty-three patients in cardiogenic shock with acute myocardial
infarction were treated using a ventricular assist system, and the results
were fairly good. The predominant indication was failure to be weaned from
cardiopulmonary bypass (72.8%), and there was no case of bridging to heart
transplantation. Left ventricular assist was performed in most patients
(85.1%). The duration of ventricular assist system application ranged from
1 hour to 70 days, and the mean duration was 6.8 +/- 9.6 days. Duration of
circulatory support had no relation to the results, and the longest support
in survivors was 25 days. The weaning rate was 50.0%, and the survival rate
was 26.2%. Main causes of death were heart failure, including unrecoverable
heart failure, and multiple organ failure. It should be kept in mind that
the decision to use a ventricular assist system should be made quickly,
before major organs, including the heart itself, are irreversibly damaged.
ARTICLES
Clinical experience with ventricular assist systems in Japan
National Cardiovascular Center, Research Institute, Osaka, Japan.
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