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Mechanical combined heart supporting system for prevention of irreversible ventricular fibrillation after experimental cardiogenic shock.

To determine whether haemodynamic effective support of the failing heart can prevent spontaneous irreversible ventricular fibrillation (IVF) after experimental cardiogenic shock, 63 open chest dogs were assigned randomly into four groups--two control groups (combined heart failure--CHF) and two MCHSS-treated (combined heart failure and non-pulsatile bypass with intraaortic counterpulsation). The CHF was produced by occlusion of the anterior descending coronary artery (group I) or the left circumflex coronary artery (group II) and by an artificial shunt between the pulmonary artery and right atrium. IVF were observed in 10 out of 22 control dogs (group I) and im 17 out of 21 control dogs (group II). In the 20 dogs with the CHF (10 animals in each group) the MCHSS was performed in the course of two hours. During the heart support no IVF were observed in any of the dogs. The difference between the incidence of IVF in the control and treated animals is statistically significant (Chi square = 21.9767 greater than Chi square 0.005).

Animals↗

Aortocoronary bypass for critical stenosis of the left main coronary artery.

Over a 2-year period 33 patients with symptomatic stenosis (greater than 75%) of the left main coronary artery underwent aortocoronary bypass. Intra-aortic balloon counterpulsation was used preoperatively in only two patients as a therapeutic measure for medically unstable angina. There were no operative deaths. Follow-up study 3 to 27 months (mean 13.3 months) after operation revealed one death. Twenty-two patients were free of pain. The authors conclude that aortocoronary bypass surgery for severe stenosis of the left main coronary artery can be safely accomplished, without prophylactic use of intra-aortic balloon counterpulsation in the majority of cases, with an acceptable operative mortality and morbidity.

Adult↗

Successful use of a left ventricular assist device in cardiogenic shock from massive postoperative myocardial infarction.

A 41-year-old man underwent an uneventful aorta-coronary bypass for unstable angina pectoris. Four hours later, a massive anterior wall myocardial infarction resulted in cardiac arrest. Conventional resuscitative means were not effective. A left ventricular assist device (LVAD) was successfully employed for 94 hours. The patient is alive and well 8 months postoperatively.

Adult↗