Concepts and Clinical Experience With a Left Ventricular Assist Device After Intracardiac Operation

Abstract

Improvements in operative management techniques in recent years have allowed a variety of successful complex open intracardiac operations even in patients with advanced left ventricular (LV) dysfunction. However, an occasional situation does arise when such an individual cannot be separated from cardiopulmonary bypass (CPB) despite aggressive use of supportive measures including use of intra-aortic balloon counterpulsation (IACP). In this fortunately rare situation the use of a mechanical means of significantly augmenting systemic blood flow while decompressing the left heart can be a life-saving measure. A number of ingenious techniques have been described to accomplish this goal and are surveyed elsewhere in this text.