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The Annals of Thoracic Surgery, Vol 57, 880-885, Copyright © 1994 by The Society of Thoracic Surgeons
LH Edmunds Jr, HC Herrmann, VJ DiSesa, MB Ratcliffe, JE Bavaria and DM McCarthy
A method to provide left ventricular circulatory assistance without
thoracotomy was developed and implemented in 2 patients. The left atrium is
cannulated from the neck by passing a catheter across the interatrial
septum (Dennis technique) using fluoroscopic and echocardiographic imaging.
To facilitate ambulation, the arterial catheter is connected to the right
axillary artery. Left atrial to axillary arterial flow is produced by a
centrifugal pump. Two patients were perfused at 2.7 to 3.5 L/min for 5 and
6.5 days. One patient had successful coronary angioplasty during perfusion
and remains alive 1 year later. The other patient died of sepsis and anuria
that preceded implementation of circulatory assistance. The Dennis method
of continuous left ventricular circulatory assistance avoids thoracotomy,
requires a minimal operation, is portable and inexpensive, uses widely
available equipment, and is particularly suitable for patients in
cardiogenic shock after acute myocardial infarction. The method is safe and
cost-effective, and merits wider application in selected patients.
ARTICLES
Left ventricular assist without thoracotomy: clinical experience with the Dennis method
Department of Surgery, School of Medicine, University of Pennsylvania, Philadelphia.
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