Percutaneous left atrial to femoral arterial bypass pumping for circulatory support in high-risk coronary angioplasty.
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 Blood was withdrawn from the left atrium and returned through a femoral arterial cannula using a roller pump.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.
Glassman
E
E
New York University College of Medicine, New York City 10016.
Chinitz
L A
LA
Levite
H A
HA
Slater
J
J
Winer
H
H
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