title: Percutaneous left atrial to femoral arterial bypass pumping for circulatory support in high-risk coronary angioplasty.
abstract: Left atrial to femoral arterial bypass was evaluated as a means of supporting patients who were considered to be at high risk for the performance of percutaneous transluminal coronary angioplasty. A 20 French drainage catheter was inserted percutaneously into the left atrium via a modified transseptal technique. Blood was withdrawn from the left atrium and returned through a femoral arterial cannula using a roller pump. Thirteen patients were treated in this fashion with excellent circulatory support. Pump flows varied from 1.5 to 3 liters per minute and bypass time ranged from 27 to 106 min (mean = 43 +/- 17). Aortic mean pressure was well supported during balloon inflation. No significant complications were encountered. Neither an oxygenator nor a perfusionist is required. The ability to obtain direct left ventricular decompression offers a major potential advantage. Further evaluation of this technique for the support of such patients is indicated.
authors.affiliation: New York University College of Medicine, New York City 10016.
authors.forename: E
authors.initials: E
authors.lastname: Glassman
authors.forename: L A
authors.initials: LA
authors.lastname: Chinitz
authors.forename: H A
authors.initials: HA
authors.lastname: Levite
authors.forename: J
authors.initials: J
authors.lastname: Slater
authors.forename: H
authors.initials: H
authors.lastname: Winer
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001243:Assisted Circulation / Q000379:methods*; D006328:Cardiac Catheterization; D003327:Coronary Disease / Q000453:epidemiology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery; D006325:Heart Atria; D006801:Humans; D008297:Male; D012307:Risk Factors; D013997:Time Factors