Univentricular support in a bridge-to-transplant experience
From July 1987 to September 1989, investigators at the Presbyterian University Hospital of the University of Pittsburgh evaluated, in lieu of the pneumatic total artificial heart , the usefulness of a left ventricular assist device as a univentricular mechanical bridge to cardiac transplantation in 14 candidates mortally ill with biventricular congestive heart failure. We acknowledged that a potentially simpler univentricular system might provide a developmental advantage over a total artificial heart en route to an idealized totally implantable system capable of long-term and quality therapy for end-stage heart disease. In part, this decision was based on our earlier experiences of an unacceptable rate of mediastinitis with the total artificial heart . We chosen the Novacor left ventricular assist system (LVAS) in its currently available temporary configuration with transcutaneous power cord because its early application as a bridge to transplant appeared promising and because its more advanced totally implantable system has already been successfully tested in animals . This report describes the results of univentricular support and focuses on its effect on right heart function and hemodynamics.
KeywordsCentral Venous Pressure Pulmonary Capillary Wedge Pressure Right Ventricular Ejection Fraction Total Artificial Heart Leave Ventricular Assist System
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