Summary
From August 1984 to July 1992, 34 patients at Osaka University Medical School and affiliated hospitals required left or biventricular assist following open heart surgery (28 patients) and other procedures (6 patients). Five children under the age of 3 years with complex cardiac lesions were supported by left ventricular assist (LVAS). Of the 29 adult patients, left ventricular assist was applied in 21 and biventricular assist in 8, for durations of 7–984 h (average: 154 h). A pneumatic diaphragm-type pump was used in 11 patients (group 1; gr. 1) and a centrifugal pump in 19 (group 2; gr. 2). Recently, four patients received a new percutaneous LVAS with a transseptal left atrial cannula and a centrifugal pump (group 3; gr. 3). Three patients (27%) in gr. 1, 13 (68%) in gr. 2, and 1 (25%) in gr. 3 were weaned from VAS. There were two survivors (18%) in gr. 1, seven (37%) in gr. 2, and none in gr. 3. Major complications in gr. 1 were bleeding (3; 27%) and right heart failure (3; 27%); in gr. 2, bleeding (6; 32%) and thromboembolism (4; 21%); and in gr. 3, bleeding (1; 25%) and low output syndrome (LOS) (1; 25%). Sixteen patients died while on VAS; eight (50%) of them had bleeding. In contrast, of the nine patients who died after being weaned from VAS only one had bleeding. Of the nine survivors, four had complications (three had thromboembolism and one had bleeding). Postoperative bleeding after the institution of VAS was the major factor affecting survival and should be avoided to achieve better results. The new percutaneous VAS, with its low incidence of complications, may be promising.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Cooley DA, Liotta D, Hallman GL, Bloodwell RD, Leachman RD, Milan JD (1969) Orthotopic cardiac prosthesis for two-staged cardiac replacement. Am J Cardiol 24:723–733
Portner PM, Oyer PE, McGregor CG, Baldwin JC, Ream AK, Wyner J, Zusman DR, Shumway NE (1985) First human use of an electrically powered implantable ventricular assist system. Artif Organs 9(A):36–42
Hill JD, Farrar DJ, Hershon JJ (1986) Use of a prosthetic ventricle as a bridge to cardiac transplantation for postinfarction cardiogenic shock. N Engl J Med 314:626–628
Pennington DG, Swartz MT (1990) Mechanical circulatory support prior to cardiac transplantation. Semin Thorac Cardiovasc Surg 2:125–134
Takano H, Nakatani T, Taenaka Y, Kitoh Y, Hiramori K, Haze K, Itoh A, Fujita T, Manabe H (1992) Treatment of acute profound heart failure by ventricular assist device. Jpn Circ J 56:100–110
Satoh H, Kobayashi T, Nakano S, Shimazaki Y, Kaneko M, Miyamoto Y, Matsuda H (1993) Clinical application of percutaneous left ventricular support with centrifugal pump (transseptal left atrial-femoral artery bypass). J ASAIO (1993 in press)
Matsuda H, Kaneko M, Matsuwaka R, Nakano S, Shirakura R, Kobayashi T, Sakai K, Sakakibara T, Masai T, Kawashima Y (1992) Recent advances in assisted circulation using centrifugal pump in surgical and non-surgical patients with acute heart failure or related conditions. Jpn Circ J 56:111–116
Oaks TE, Pae WE, Miller CA, Pierce WS (1991) Combined registry for the clinical use of mechanical ventricular assist pumps and the total artificial heart in conjunction with heart transplantation: Fifth official report — 1990. J Heart Lung Transplant 10:621–625
Pierce WS, Parr GVS, Myers JL, Pae WE, Bull AP, Waldhausen JA (1981) Ventricular-assist pumping in patients with cardiogenic shock after cardiac operations. N Engl J Med 305:1606–1610
Farrar DJ, Hill JD, Gray LA, Pennington DG, McBride LR, Pierce WS, Pae WE, Glenville B, Ross D, Galbraith TA, Zumbro GL (1988) Heterotopic prosthetic ventricles as a bridge to cardiac transplantation. N Engl J Med 318:333–340
Pennington DG, McBride LR, Swartz MT, Kanter KR, Kaiser GC, Barner HB, Miller LW, Naunheim KS, Fiore AC, Willman VL (1989) Use of the Pierce-Donachy ventricular assist device in patients with cardiogenic shock after cardiogenic operations. Ann Thorac Surg 47:130–135
Hill JD (1989) Bridging to cardiac transplantation. Ann Thorac Surg 47:167–171
Johnson KE, Prieto M, Joyce LD, Pritzker M, Emery RW (1992) Summary of the clinical use of the Symbion total artificial heart: A registry report. J Heart Lung Transplant 11:103–116
Frazier OH, Rose EA, Macmanus Q, Burton NA, Lefrak EA, Poirier VL, Dasse KA (1992) Multicenter clinical evaluation of the HeartMate 1000 IP left ventricular assist device. Ann Thorac Surg 53:1080–1090
Portner PM, Oyer PE, Pennington DG, Baumgartner WA, Griffith BP, Frist WR, Magilligan DJ, Noon GP, Ramasamy N, Miller PJ, Jassawalla JS (1989) Implantable electrical left ventricular assist system: Bridge to transplantation and the future. Ann Thorac Surg 47:142–150
Miyamoto Y, Kormos RL, Borovetz HS, Gaisor T, Pristas JM, Armitage JM, Hardesty RL, Griffith BP (1990) Hemodynamic parameters influencing clinical performance of Novacor left ventricular assist system. Artif Organs 14:454–457
Kormos RL, Borovetz HS, Gaisor T, Antaki JF, Armitage JM, Pristas JM, Hardesty RL, Griffith BP (1990) Experience with univertricular support in mortally ill cardiac transplant candidates. Ann Thorac Surg 49:261–272
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1993 Springer Japan
About this chapter
Cite this chapter
Miyamoto, Y., Nakano, S., Kaneko, M., Matsuwaka, R., Satoh, H., Matsuda, H. (1993). Analysis of Complications Affecting Survival After Employment of Ventricular Assist System (VAS) Using Pneumatic and Centrifugal Pumps. In: Akutsu, T., Koyanagi, H. (eds) Heart Replacement. Springer, Tokyo. https://doi.org/10.1007/978-4-431-67023-0_31
Download citation
DOI: https://doi.org/10.1007/978-4-431-67023-0_31
Publisher Name: Springer, Tokyo
Print ISBN: 978-4-431-67025-4
Online ISBN: 978-4-431-67023-0
eBook Packages: Springer Book Archive