Clinical consideration of LVAD system for cardiogenic shock patients

Abstract

LVAD has been used in 16 patients, 9 of whose entire circulation was well maintained at normal level and LVAD was successfully removed. To maintain the major organ functions in normal level, systemic flow and SvO₂ should be kept above 3.0l/min/m² and 65%, and lactate level below 10mg/dl. Although the natural heart could recover, the most patients died of multiple organ failure which developed during prolonged ischemia prior to LVAD assistance. In clinical situation, timely use of LVAD by right judgement is important. Aortocoronary bypass should be performed within 2 hours after the onset of infarction to prevent hemorrhagic infarction. To prevent thromboembolism originated from left ventricle, anticoagulant should be administered earlier and full bypass should be avoided.