title: Clinical experience of left ventricular assist systems at the Heart Institute of Japan.
abstract: The main indications for left ventricular assist system (LVAS) support are postcardiotomy ventricular failure as temporary circulatory support and end-stage cardiomyopathy as chronic circulatory support. To clarify the efficacy of LVAS support, we assessed the clinical outcome of a pneumatic LVAS and an electromagnetic LVAS for patients with severe ventricular failure. As of March 1998, 5 patients with postcardiotomy ventricular failure had received the pneumatic LVAS support, and 2 other patients with end-stage idiopathic cardiomyopathy had undergone implantation of the electromagnetic LVAS. The drive control of the LVAS was mainly counterpulsation in the diastole of the native heart. In the 5 postcardiotomy patients, the duration of pneumatic LVAS support ranged from 30 to 312 h (mean, 109.2). All 3 patients with more than 72 h support were successfully weaned, and 2 of them survived. The other 2 patients with cardiogenic shock and less than 36 h support could not be weaned from the LVAS. In the 2 cardiomyopathy patients, 1 patient was well maintained by the electromagnetic LVAS support and underwent successful heart transplantation 7 months later. The other patient has been chronically supported by the LVAS for 2 months and is doing well so far. These results suggest that selective application of the pneumatic LVAS as a temporary support and the electromagnetic LVAS as a chronic support might be appropriate for maximizing the effectiveness of LVAS treatment for profound cardiac failure.
authors: Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical University, Japan.
authors: M
authors: M
authors: Kitamura
authors: A
authors: A
authors: Kawai
authors: M
authors: M
authors: Hachida
authors: H
authors: H
authors: Nishida
authors: M
authors: M
authors: Endo
authors: H
authors: H
authors: Koyanagi
mesh_terms: D000328:Adult; D002303:Cardiac Output, Low / Q000209:etiology / Q000628:therapy; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D009202:Cardiomyopathies / Q000628:therapy; D005260:Female; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D012770:Shock, Cardiogenic / Q000628:therapy