LEFT-VENTRICULAR ASSIST WITHOUT THORACOTOMY - CLINICAL-EXPERIENCE WITH THE DENNIS METHOD

A method to provide left ventricular circulatory assistance without th oracotomy was developed and implemented in 2 patients. The left atrium is cannulated from the neck by passing a catheter across the interatr ial septum (Dennis technique) using fluoroscopic and echocardiographic imaging. To facilitate ambulation, the arterial catheter is connected to the right axillary artery. Left atrial to axillary arterial now is produced by a centrifugal pump. Two patients were perfused at 2.7 to 3.5 L/min for 5 and 6.5 days. One patient had successful coronary angi oplasty during perfusion and remains alive 1 year later. The other pat ient died of sepsis and anuria that preceded implementation of circula tory assistance. The Dennis method of continuous left ventricular circ ulatory assistance avoids thoracotomy, requires a minimal operation, i s portable and inexpensive, uses widely available equipment, and is pa rticularly suitable for patients in cardiogenic shock after acute myoc ardial infarction. The method is safe and cost-effective, and merits w ider application in selected patients.