Abstract
A new left ventricular (LV) assist device, Integrated Cardioassist Catheter (ICAC) has been developed for pulsatile left ventricular flow support. This device is made up of a transaortic valve LV draining tube and a concomitant intraaortic balloon as a single apparatus. The draining tube is inserted from the femoral artery percutaneously into the LV via the aortic valve, and the blood is returned by another cannula inserted percutaneously from the opposite side femoral artery. Pulsatile flow could be added to LV bypass by means of a synchronously operated balloon in the descending aorta.
As for an instanteneous insertion of this ICAC, a pig-tail catheter with an internal guide wire is first passed through the lumen of the draining tube into the LV. When the pig-tail catheter is confirmed to be in an ideal position with portable fluoroscopy, the tube is advanced. As soon as the tip of the ICAC is inserted into the LV, it is connected to a centrifugal pump and IABP console. It took only 3-4 minutes to insert and then drive, after the arteries are exposed in canine experiment. Application of pig-tail catheter made insertion easier without any complications.
With this method, the device can be applied by percutaneous insertion emergently for patients with severe LV dysfunction in the ICU, the CCU or the operating room.
