Biomedical subjects

Louis E Samuels

Publications and source records attributed to Louis E Samuels.

21 records · Page 2Linked to original sources

PubMed2003

Improved survival with ventricular assist device support in cardiogenic shock after myocardial infarction.

BACKGROUND: Cardiogenic shock after acute myocardial infarction is associated with a very high mortality rate. METHODS: A retrospective review was performed of records of all patients supported with an Abiomed device at our institution between 1994 and 2002 to identify those patients who underwent device insertion for the treatment of acute myocardial infarction complicated by cardiogenic shock (AMI-CS). RESULTS: Seventeen patients who were suffering from AMI-CS and for whom medical management was failing were supported using the Abiomed BVS 5000. The average age of these patients was 57.6 years. Eleven patients were suffering primarily from left ventricular dysfunction and were supported with a left ventricular assist device (LVAD). Eight of these patients were weaned from device support, a nd 6 survived to hospital discharge (54%). In contrast, 6 patients presented with biventricular failure and were supported with biventricular VADs (BiVADs). None of these BiVAD patients could be weaned from device support. Two BiVAD patients underwent cardiac transplantation, and only one survived. CONCLUSION: In the presence of left ventricular failure producing cardiogenic shock after myocardial infarction, LVAD support can produce a 54% survival rate in those patients w ho are failing medical management. However, in patients in biventricular failure after myocardial infarction, BiVAD support may be used to stabilize the patient until transplantation, but the overall prognosis remains poor.

Adult↗

PubMed2002

Ruptured right coronary artery aneurysm presenting as a myocardial mass.

Rupture of a coronary artery aneurysm may result in a contained hematoma and an intramyocardial mass. We present a case of a contained coronary artery aneurysm rupture presenting as a mass in the right ventricle. The mass was suspected in a preoperative transthoracic echocardiogram and identified at the time of elective coronary artery bypass surgery. We discuss the pathophysiology, clinical presentation, diagnostic features, and management of this uncommon clinical presentation.

Aneurysm, Ruptured↗

PubMed2002

Ventricular assist device support for management of sustained ventricular arrhythmias.

We describe herein the cases of 2 patients who had ventricular arrhythmias. In one, a short-term biventricular assist device, the ABIOMED BVS 5000, was placed because the patient had sustained ventricular tachycardia and could not be weaned from cardiopulmonary bypass. Excellent hemodynamic support was maintained for several days while the antiarrhythmic therapy was maximized. Sinus rhythm was restored, and the patient was successfully weaned from the ventricular assist device. However, the substrate for the arrhythmia persisted, and a recurrence, 1 week later, resulted in the patient's death. In the 2nd patient, the use of an implantable left ventricular assist device was successful in temporarily alleviating the ventricular tachycardia associated with ischemic cardiomyopathy. However, after 2 days of device assistance, the patient experienced a recurrence of the tachycardia, which degenerated into ventricular fibrillation with a marked deterioration in the patient's hemodynamics. The arrhythmia persisted despite multiple attempts at external cardioversion, and internal cardioversion and placement of an automatic implantable cardioverter-defibrillator were necessary. This treatment, along with repeated boluses of amiodarone, led to successful suppression of the arrhythmias, and the patient eventually underwent transplantation. The mechanical hemodynamic support of the circulation by ventricular assist devices was effective in supporting these 2 patients who had sustained ventricular arrhythmias.

Female↗