[Circulatory compensation experience to date (author's transl)].
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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.
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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.
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Diverse ways of a cardiophased action on the cardio-vascular system for therapeutic and diagnostic purposes are assessed. Requirements for the basic subunits of the assisted circulation apparatus to be met, the possibilities open for developing automatic cardiosynchronization systems, and also features peculiar to the synchronization mode in effecting coronarography and conditions necessary for implementation of the method for elective introduction of liquid agents into the supravalvular space of the aorta are discussed.
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