Abstract
We have used our automatic VAS in 20 patients (pts) with post-cardiotomy profound heart failure. Twelve of 20 pts were weaned and 3 were discharged from the hospital. We reviewed these pts to clarify the problems in clinical application of VAS. (1) Delayed application of VAS developed multiple organ failure. (2) In our series, LVAS could maintain the circulation with volume loading and catecholamines even if right ventricular failure was coexisted. (3) Evaluation of natural heart (NH) function by echocardiography, automatic level control on left atrial pressure (LAP) and flow, and a composite driving system for LVAS and IABP were practical and effective in hemodynamic control and weaning process from LVAS. (4) LV thrombus were detected in the pts with severely depressed NH function. Intra-LV heparinization was effective to prevent thrombus formation in LV. (5) Possibility of recovery of NH could be predicted from corrected ejection time/LAP. In conclusion, timely application and careful management are important to save the VAS pts.
