Abstract
As of 1992 pneumatic ventricular assist device (VAD) has been applied for profound heart failure in 16 postcardiotomy patients. Average assist duration was 86 hours and left ventricular assist device in 13 patients and right ventricular assist device in 3 patients. Weaning rate from the device was 66% and survival rate was 20%. Causes of death were multi-organ failure in 40%, ventricular failure in 25%. Infection and thromboembolic complications were not observed during support. Optimization of assist flow has been achieved by monitoring hemodynamic and echocardiographic data. Hemodynamic criteria for weaning from the device has also been established; cardiac index>2.5L/min/m2, pulmonary capillary wedge pressure < 15mmHg, etc. Monitoring of the coagulation system has also been important for avoiding multi-organ failure and getting long-term survival. The results have suggested that this system is versatile for profound heart failure in postcardiotomy setting and could also be applied as a short-term or intermediate-term device for emergent setting and bridge-to-transplant patients. We reviewed our experience using the Nippon Zeon ventricular assist system and introduced clinical experience of ventricular assist device application of Baylor College of Medicine in Houston, U.S.A. and discussed about the problems of assist devices.
