Paracorporeal Artificial Heart in Postoperative Heart Failure

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Abstract
A pneumatically driven artificial heart with a tubular silicone rubber membrane and disc valves was used for functional heart replacement in the paracorporeal mode. A fluidic drive system allows adjustment of the heart rate, positive and negative pressures and systole/diastole ratio. The artificial heart was used in 4 patients with refractory postoperative heart failure not responding to volume loading, pH and electrolyte correction, catecholamines and intra-aortic balloon pumping. Large cannulae were placed in the atria and great vessels. The ventricles were fixed on the chest paracorporeally. The assist system was used as a left heart bypass in 1 patient and as a biventricular bypass in 1 patient and as a biventricular bypass in 3 other patients. After 48-72 h, ventricular function recovered in 3 patients, permitting removal of the artificial heart. One patient died of cerebral complications 6 wk later; the other 2 recovered completely and were released in good condition. Profound postoperative heart failure can be completely reversed by the use of the paracorporeal artificial heart; the advantage of the system lies in the simplicity of its implantation and removal.

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