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Ann Thorac Surg 1996;62:681-682
© 1996 The Society of Thoracic Surgeons

Discussion

Discussion

The first 300 words of the full text of this article appear below.

See also page 675.

DR ROLAND HETZER (Berlin, Germany): I am most grateful to have the opportunity to comment on this very important contribution of Dr Frazier and associates which, in my opinion, marks the opening of a promising new era in the treatment of patients with chronic myocardial failure. Our own experience strongly supports the expectation of recovery to normal function in the hearts of many patients who as of now we had considered transplant candidates as the only option. Up to now we have explanted left ventricular assist devices in 4 patients after complete or near complete cardiac recovery after prolonged support of between 160 and 347 days. All 4 are men, ranging in age from 38 to 58 years. All had the clinical findings of dilated cardiomyopathy that had developed years after viral myocarditis in 3 and chronic alcohol intake in 1. At the time of assist implantation, all were on maximum intravenous inotropic support and death was expected to occur within days. Three received a Novacor system and 1 a pneumatic TCI HeartMate system.

At time of assist implantation, cardiac index was less than 1.8 L • min-1 • m-2 in all, left ventricular diastolic diameter was between 69 and 72 mm, left ventricular ejection fraction was estimated at less than 0.15. During the following months and on repeat pump-off studies, left ventricular diastolic diameter decreased to normal sizes, between 52 and 55 mm, and left ventricular ejection fraction increased to between 0.48 and 0.55.

These parameters have not shown relapse of failure since assist explantation between 4.5 and 11 months ago. On the contrary, there has been a slight further improvement during follow-up. The pumps were explanted leaving both inflow and outflow cannula in place.

Beta-1-receptor autoantibodies were found at high levels at the time . . . [Full Text of this Article]


Related Article

Improved Left Ventricular Function After Chronic Left Ventricular Unloading
O. H. Frazier, Claude R. Benedict, Branislav Radovancevic, Roger J. Bick, Pavel Capek, William E. Springer, Michael P. Macris, Reynolds Delgado, and L. Maximilian Buja
Ann. Thorac. Surg. 1996 62: 675-681. [Abstract] [Full Text]





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Copyright © 1996 by The Society of Thoracic Surgeons.