A servocontrolled atrial-aortic assist device: experimental findings and clinical experience.
A servocontrol system was developed to regulate a single roller pump left atrial-aortic (La-A) assist device. Responsiveness of the servomechanism to blood volume changes, myocardial damage, and mitral regurgitation was evaluated in 5 sheep and 6 dogs. Myocardial damage was induced by occlusion of coronary arteries. and the hemodynamic effects of La-A assistance were evaluated. While La-A assistance reduced left atrial pressures to low levels, the left ventricular end-diastolic pressure remained elevated in the severely damaged heart. LaA-assistance was used in 3 patients. Two were weaned from cardiopulmonary bypass after failure of intraaortic balloon counterpulsation, and 1 is a long-term survivor. The third was supported for 48 hours after attempt repair of complex congenital heart disease. The servocontrol device added to the safety of prolonged La-A assistance. This mode of assistance should be considered when intraaortic balloon counterpulsation has failed.
D000293:Adolescent; D000328:Adult; D000818:Animals; D001243:Assisted Circulation / Q000295:instrumentation*; D004285:Dogs; D005260:Female; D006322:Heart Aneurysm / Q000601:surgery; D006330:Heart Defects, Congenital / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000295:instrumentation; D012756:Sheep