HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Champsaur, G. Articles by Boissonnat, P. Search for Related Content PubMed PubMed Citation Articles by Champsaur, G. Articles by Boissonnat, P.

The Journal of Thoracic and Cardiovascular Surgery, Vol 100, 122-128, Copyright © 1990 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Use of the Abiomed BVS System 5000 as a bridge to cardiac transplantation

G Champsaur, J Ninet, M Vigneron, P Cochet, J Neidecker and P Boissonnat
Hopital Cardiovasculaire et Pneumologique, Universite Claude Bernard, Lyon, France.

The Abiomed BVS System 5000 (Abiomed Cardiovascular, Inc., Danvers, Mass.) is a gravity-filled, pneumatically driven external prosthetic ventricle that has been implanted as a circulatory support device in six patients 9 to 58 years of age, presenting with a refractory heart failure nonamenable to any type of corrective operation. Three (including a 9-year-old girl) had an end-stage nonobstructive myocardiopathy, and two (including one patient who had had a massive recent myocardial infarction) had an ischemic heart disease. When first seen, the 58-year-old patient had an acute rejection and graft failure occurring 2 months after a first transplantation. All patients showed evidence of a low-output state (cardiac index less than 1.5 L/min/m2), with renal failure (mean urinary output, less than 27 ml/min) and hypoxia (mean arterial oxygen pressure = 56 torr under 80% forced inspiratory oxygen), despite maximum pharmacologic support (dobutamine, 16 to 18 gamma/kg/min; dopamine, 3 to 18 gamma/kg/min; adrenaline, 0.2 to 0.7 gamma/kg/min; furosemide, 7 to 17 gamma/kg/min). The device was implanted through a midline sternotomy and under peripheral normothermic bypass. Five patients received a biventricular support, and one a single left prosthetic ventricle. The cannulation included a right-angled cannula in both the left and right atrium and a suture of the arterial Dacron tubes onto the ascending aorta and main pulmonary artery. After careful deairing of the tubing and ventricles, the console was activated and the bypass progressively discontinued. Heparin infusion was begun 3 hours after chest closure and was continued for the duration of assist pumping, which was 2 to 11 days (mean duration, 7.43 days). The system could provide a complete support of the circulation with both right and left ventricular index remaining stable at 2.4 to 3 L/min/m2. After a dramatic improvement at the time of the system activation, the urinary output remained adequate, thus allowing for a decreasing need for diuretic therapy. In two cases, including one of isolated left ventricular assist pumping, the circulation could be totally supported during 11 hours and 23 hours, respectively, of refractory ventricular tachycardia. Four of six patients were shortly weaned from inotropic agents. Hematologic studies showed a moderate decrease of the coagulation factors level during the first 6 hours of circulatory support, and this remained stable and within normal limits thereafter. There have been three cases of bleeding complications necessitating surgical revision on the sixth hour, the twelfth hour, and the sixth day, respectively.(ABSTRACT TRUNCATED AT 400 WORDS)

This article has been cited by other articles:

				H. Tatewaki, M. Masuda, T. Nishida, Y. Kaji, H. Ushinohama, S. Morita, and H. Yasui Successful Treatment of Tachycardia-Induced Cardiomyopathy With LVAD in a 12-Year-Old Boy Ann. Thorac. Surg., August 1, 2005; 80(2): e5 - e7. [Abstract] [Full Text] [PDF]

				A. Y. Schure, P. C. Laussen, and F. X. McGowan JR Mechanical Cardiopulmonary Support of Infants and Children With Congenital Heart Disease Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2001; 5(1): 46 - 54. [Abstract] [PDF]

				A. M. Sadeghi, D. Marelli, M. Talamo, D. Fazio, and H. Laks Short-term bridge to transplant using the BVS 5000 in a 22-kg child Ann. Thorac. Surg., December 1, 2000; 70(6): 2151 - 2153. [Abstract] [Full Text] [PDF]

				D. Marelli, H. Laks, D. Fazio, M. A. Hamilton, G. C. Fonarow, D. A. Meehan, and J. D. Moriguchi Mechanical assist strategy using the BVS 5000i for patients with heart failure Ann. Thorac. Surg., July 1, 2000; 70(1): 59 - 66. [Abstract] [Full Text] [PDF]

				P A. Wassenberg The Abiomed BVS 5000 biventricular support system Perfusion, July 1, 2000; 15(4): 369 - 371. [PDF]

				R. Korfer, A. El-Banayosy, L. Arusoglu, K. Minami, T. Breymann, D. Seifert, and L. Kizner Temporary pulsatile ventricular assist devices and biventricular assist devices Ann. Thorac. Surg., August 1, 1999; 68(2): 678 - 683. [Abstract] [Full Text] [PDF]

				M Lachat, C Jaggy, B Leskosek, R Jenni, M Buchi, G Zund, A Kunzli, P Vogt, and M Turina Optimized performance of the Abiomed BVS 5000: adjustment of the pump height based on Doppler control of the flow pattern Perfusion, January 1, 1999; 14(1): 59 - 67. [Abstract] [PDF]

				J. Robin, S. Martinot, A. Curtil, C. Vedrinne, F. Tronc, M. Franck, and G. Champsaur Experimental right ventricle to pulmonary artery discontinuity: Outcome of polyurethane valved conduits J. Thorac. Cardiovasc. Surg., April 1, 1998; 115(4): 898 - 903. [Abstract] [Full Text] [PDF]

				D. Shum-Tim, B. W. Duncan, V. Hraska, I. Friehs, T. Shin'oka, and R. A. Jonas Evaluation of a Pulsatile Pediatric Ventricular Assist Device in an Acute Right Heart Failure Model Ann. Thorac. Surg., November 1, 1997; 64(5): 1374 - 1380. [Abstract] [Full Text]

				A. El-Banayosy, H. Posival, K. Minami, L. Arusoglu, L. Kizner, T. Breymann, D. Seifert, M. Korner, H. Kortke, O. Fey, et al. Mechanical circulatory support: lessons from a single centre Perfusion, March 1, 1996; 11(2): 93 - 102. [Abstract] [PDF]

				T. W. Prendergast, A. E. Ortega, V. A. Starnes, T. M. Klein, and M. L. Barr Safe Application of Diagnostic Laparoscopy During Biventricular Assistance Ann. Thorac. Surg., February 1, 1996; 61(2): 735 - 737. [Abstract] [Full Text]

				R. Korfer, A. El-Banayosy, H. Posival, K. Minami, L. Kizner, L. Arusoglu, and M. M. Korner Mechanical Circulatory Support With the Thoratec Assist Device in Patients With Postcardiotomy Cardiogenic Shock Ann. Thorac. Surg., January 1, 1996; 61(1): 314 - 316. [Abstract] [Full Text]