PERCUTANEOUS LEFT-VENTRICULAR ASSIST SYSTEM USING A MODIFICATION OF THE DENNIS METHOD - INITIAL CLINICAL-EVALUATION AND RESULTS

A percutaneous left ventricular assist system (PLVAS) using a modifica tion of the Dennis method was developed and implemented in 8 patients, Transseptal cannulation was performed under biplane fluoroscopy and/o r transesophageal echocardiogram without encountering any problems, Al l the patients were in a state of severe cardiogenic shock, caused by acute myocardial infarction in 5, cardiomyopathy in 2, and postcardiot omy in 1, and were on intraaortic balloon pump support and/or percutan eous cardiopulmonary support (PCPS), in the form of partial cardiopulm onary bypass, Three patients who developed concomitant right heart fai lure required additional PCPS. All the patients were supported at 3.0 to 4.0 l/min for 76-284 h for an average time of 159 h. Three patients were successfully weaned from PLVAS and one of these patients, who ha d suffered an acute myocardial infarction, was discharged from hospita l. The complications directly related to this system were minimal. Our observations led to the conclusion that PLVAS using our modification of the Dennis method is a simple, easy, and safe means of maintaining adequate systemic circulation in severely ill patients, As PLVAS is pa rticularly effective for patients in cardiogenic shock following acute myocardial infarction, we believe that it will be applied routinely b y many cardiac surgeons and cardiologists in the future.