Assisted Circulation

J. Navratil The performance of operations on the heart and its replacement by a trans­ planted or artificial heart has been an age old dream of man. Rehn for example in an early attempt, in 1868 performed a closure of a heart wound after a thoracic puncture. At that time noone thought that this attempt was the beginning of cardiac surgery. The dream was partially realized when the replacement of the heart function by the heart-lungmachine became possible. Immediately following the first operations, cardiac surgeons and cardiologists saw with great enthusiasm that this machine could be an important tool for correcting congenital and non­ congenital heart diseases. However, the heart-lungmachine was soon seen to not be an optimal instrument for controlling cardiac failure after cardiopulmonary bypass or myocardial infarction. then arose for the development of mechanical assistance to the heart. Concepts The rollerpump was first designed for assisted circulation and could be applied clinically in 1962. A new concept of mechanical assistance to the heart was pro­ vided by the intra aortic balloon pump and later by the bypass ventricles. Use of the intra aortic balloon pump can reduce cardiac work by counterpulsation in accord with the natural ECG. The bypass ventricle can functionally replace the heart in series or parallel to the natural heart. The intra aortic balloon pump, now an established method, has reduced the number of patients who used to die from cardiac failure. Front Matter....Pages I-XXIII Historical Background....Pages 1-2 Introduction....Pages 3-6 Medical Research and the Doctor’s Conscience....Pages 7-10 Questions and Predictions....Pages 11-12 Front Matter....Pages 13-13 Introduction....Pages 15-19 Counterpulsation: Foundation and Future, with a Tribute to William Clifford Birtwell (1916–1978)....Pages 20-23 Intra-aortic Balloon Pumping: Current Status and Prospects....Pages 24-30 Clinical Experience with Intra-aortic Balloon Pumping and the Pulsatile Assist Device....Pages 31-39 Clinical Results of Intra-aortic Balloon Pumping in Selected Groups of Patients....Pages 40-46 Indications for Intra-aortic Balloon Pumping....Pages 47-55 Changing Role of Cardiac Assistance in the Management of Myocardial Infarction Shock....Pages 56-66 The State of Assisted Circulation in the USSR....Pages 67-70 The Present Status of External Counterpulsation....Pages 71-78 Hemodynamic Response to External Counterpulsation....Pages 79-84 Front Matter....Pages 85-85 Introduction....Pages 87-95 A Left Ventricular Aortic Blood Pump for Circulatory Support in Postoperative Patients With Acute Left Ventricular Failure....Pages 96-106 An Intracorporeal (Abdominal) Left Ventricular Assist Device: Initial Clinical Trials (LX)....Pages 107-126 The Ellipsoid Left Ventricular Assist Device: Experimental and Clinical Results....Pages 127-137 Design and Evaluation of a Left Ventricular Assist Device: The Angle Port Pump....Pages 138-146 An Efficient Electromechanical Left Ventricular Assist Device....Pages 147-160 Front Matter....Pages 85-85 Toward a Blood Pump for Long-Term Left Ventricular Assist Device....Pages 161-170 Servo-Controlled Cardiac Assistance: The Effects of Left Ventricular-to-Aortic and Left Atrial-to-Aortic Assistance on Infarct Size....Pages 171-179 Atrio-Aortic Left Ventricular Assist Device....Pages 180-190 Left Ventricular Assistance With a Double-Chambered Alternate Pumping Device....Pages 191-198 Concepts and Clinical Experience With a Left Ventricular Assist Device After Intracardiac Operation....Pages 199-208 Experimental and Clinical Left or Biventricular Assist Device with Local Heparinization and Blood Filtration....Pages 209-217 Low Flow Right Atrial and Left Ventricular Assist Device Without an Oxygenator for Cardiogenic Shock. A Revised Concept....Pages 218-230 A Centrifugal Pump for Circulatory Assistance....Pages 231-242 Partial or Total Heart Substitution with a Double-Centrifugal Device — Theoretical and Physiologic Studies....Pages 243-257 Pulmonary Hemodynamics and Gas Exchange During Venoarterial Bypass with Membrane-Lung Oxygenation....Pages 258-266 Aortic Arch Perfusion Modes in Partial and Total Cardiopulmonary Bypass....Pages 267-275 Front Matter....Pages 277-277 Introduction....Pages 279-282 The Total Artificial Heart — a Research Tool or Potential Clinical Reality....Pages 283-306 The State of the Art of the Berlin Total Artificial Heart — Technical Aspects....Pages 307-334 Experimental Results on Long-Term Survivals (over 1 Month) with a Total Artificial Heart....Pages 335-343 Design of the Pennsylvania State University Artificial Heart and Electronic Automatic Control System....Pages 344-352 The Ellipsoidheart in Total Artificial Heart Replacement....Pages 353-371 Control Systems for the Total Artificial Heart....Pages 372-381 The State of Total Artificial Heart in the USSR....Pages 382-387 Total Artificial Heart Replacement With Consecutive Heart Transplantation....Pages 388-393 Front Matter....Pages 395-395 The Clinical Application of Implanted Natural Auxiliary Hearts....Pages 397-405 Current Status of Heart Transplantation: the Stanford Experience....Pages 406-413 Experimental Auxiliary Heart Transplantation....Pages 414-426 Front Matter....Pages 427-427 Drive and Management of Circulation Support Systems....Pages 429-453 Control of Electric Pneumatic Driving Systems....Pages 454-472 The Electrically Driven Left Ventricular Assist Device....Pages 473-479 Front Matter....Pages 481-481 Material Aspects of Cardiac Assist Devices: the Case History of Avcothane 51 Elastomer....Pages 483-496 Some Current Problems and New Dimensions of Polymeric Biomaterials for Blood Contacting Applications....Pages 497-505 Hydrophobic Polymers as Materials for Interfacing with Blood....Pages 506-519 Carbon Cardiovascular Devices....Pages 520-532 Hemolysis in Artificial Heart Valves due to High-Level, Short-Duration Laminar Shear Stress....Pages 533-540 Current Literature 1.1.1975–31.12.1978....Pages 541-559 Places Where Assisted Circulation is Performed....Pages 561-567 Summaries....Pages 569-631 Front Matter....Pages 633-633 E. S. Bücherl....Pages 635-635 D. A. Cooley....Pages 636-637 M. E. DeBakey....Pages 638-639 P. Frommer....Pages 640-643 F. Gschnitzer....Pages 644-644 S. D. Moulopoulos....Pages 645-647 Front Matter....Pages 633-633 Y. Nosé....Pages 648-648 K. Polzer....Pages 649-649 Å Senning....Pages 650-650 J. T. Watson....Pages 651-652 Back Matter....Pages 653-656

Assisted Circulation 4 is an authoritative review of the progress which has been achieved in the last 5 years since the publication of Assisted Circulation 3 in 1989. The present book highlights the work of well-known experts on indications for assisted circulation, cardiac support devices such as bridges, devices for transplantation, devices for chronic mechanical support, biological energy sources, cardiomyoplasty, extracorporeal membraneoxygenation and an overview of cardiac devices support with a specific emphasis on xenotransplantation. Assisted Circulation 4 is the latest product of an ongoing effort by the editors to keep readers regularly informed of recent developments in the field. Assisted Circulation is a standard technology in cardiac surgery and especially in cardiac transplantation.

The book contains black-and-white illustrations.