Percutaneous left ventricular assist system using a modification of the Dennis method: initial clinical evaluation and results

Abstract

A percutaneous left ventricular assist system (PLVAS) using a modification of the Dennis method was developed and implemented in 8 patients. Transseptal cannulation was performed under biplane fluoroscopy and/or transesophageal echocardiogram without encountering any problems. All the patients were in a state of severe cardiogenic shock, caused by acute myocardial infarction in 5, cardiomyopathy in 2, and postcardiotomy in 1, and were on intraaortic balloon pump support and/or percutaneous cardiopulmonary support (PCPS), in the form of partial cardiopulmonary bypass. Three patients who developed concomitant right heart failure required additional PCPS. All the patients were supported at 3.0 to 4.0 l/min for 76-284h for an average time of 159h. Three patients were successfully weaned from PLVAS and one of these patients, who had suffered an acute myocardial infarction, was discharged from hospital. The complications directly related to this system were minimal. Our observations led to the conclusion that PLVAS using our modification of the Dennis method is a simple, easy, and safe means of maintaining adequate systemic circulation in severely ill patients. As PLVAS is particularly effective for patients in cardiogenic shock following acute myocardial infarction, we believe that it will be applied routinely by many cardiac surgeons and cardiologists in the future.