Abstract
A pulsatile left ventricular assist catheter(transaortic valve from left ventricle to lemoral artery)consisting of bypass tube(90cm in length and 15 Fr in inner diameter)and an accompanying intraaortic balloon as a single apparatus(Integrated cardioassist catheter; ICAC)has been developed. We have experienced first clinical application of the ICAC as a treatment for cardiogenic shock. When a 61 year old man with a myocardial infrction was admitted, the ECG revealed ventricular flbrillation. After the institution of a 3L/min. of PCPS flow support and IABP, coronary angiography and PTCA were perlormed. Because urine production decreased gradually and left ventricular function detected by TEE was depressed, the ICAC took the place of the PCPS. It took 30min. to change the cannulations, thereafer the left ventricular bypass was adjusted to 1.8L/min, with counterpulsation with the aid of a centrifugal pump and IABP console. After the application of ICAC, the urine production increased and left ventricular ejection fraction rose, however, the patient became unconscious and died six days alter admission due to cerebral infarction and hemorrhage. This clinical experience suggested that the ICAC enabled quickly institution of left heart bypass and was beneficial to left heart support.
