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J Thorac Cardiovasc Surg 1996;111:55-61
© 1996 Mosby, Inc.

CARDIOPULMONARY BYPASS, MYOCARDIAL MANAGEMENT, AND SUPPORT TECHNIQUES

A VAVLELESS HIGH STROKE VOLUME COUNTERPULSATION DEVICE RESTORES HEMODYNAMICS IN PATIENTS WITH CONGESTIVE HEART FAILURE AND INTRACTABLE CARDIOGENIC SHOCK AWAITING HEART TRANSPLANTATION

Athens, Greece

Received for publication Dec. 27, 1994. Accepted for publication March 16, 1995. Address for reprints: John N. Nanas, MD, University of Athens School of Medicine, Department of Clinical Therapeutics, "Alexandra" Hospital, Vas. Sofias Ave. and 2 K. Lourou St., GR: 115 28, Athens, Greece.

Abstract

The paraaortic counterpulsation device is a round pumping chamber with one valveless opening 20 mm in diameter and a 100 ml stroke volume. The paraaortic counterpulsation device was implanted on the ascending aorta of three male patients with intractable cardiogenic shock. Patients were assisted for 4 hours and 8 and 54 days, respectively; the first patient died as a result of nonresponding peripheral vasodilation and the other two died of septic shock. The two patients who were assisted for 8 and 54 days were conscious and able to function in a limited manner during the mechanical assistance. Discontinuation of the mechanical support for a few seconds was followed by low systolic arterial pressure (30 to 60 mm Hg) and syncopal episodes. Biochemical tests and autopsy results in these patients showed no evidence of blood cell destruction, thrombus formation, brain infarction, or other distal emboli. In conclusion, satisfactory hemodynamic effects, excellent biocompatibility, and simplicity of the implantation procedure in these patients encourage the use of the paraaortic counterpulsation device as a bridge to heart transplantation. (J THORACCARDIOVASCSURG1996;111:55-61)

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