Treatment of cardiogenic shock with the hemopump left ventricular assist device

Wampler, Richard K.; Frazier, O.H.; Lansing, Allan M.; Smalling, Richard W.; Nicklas, John M.; Phillips, Steven J.; Guyton, Robert A.; Golding, Leonard A.R.

doi:10.1016/0003-4975(91)90913-b

Cited by 78 publications

(19 citation statements)

References 13 publications

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“…device is the same as the 21 Fr. device [7,8]: the inflow cannula is positioned across the aortic valve with the inlet residing in the left ventricle and the pump outlet positioned above the aortic valve. During operation of the pump, the ventricle is actively decompressed and blood flow is delivered to the aorta (Fig.…”

Section: Fr Hemopumpo Systemmentioning

confidence: 99%

“…Clinical trials were conducted in the United States to evaluate the system in the treatment of potentially reversible cardiogenic shock. These trials demonstrated significant improvement in the hemodynamic condition of patients with shock and improvement in survival of selected patients [8]. However, the large diameter of the pump prevented successful placement in 23% of patients and thus posed a significant barrier to its clinical use.…”

Section: Introductionmentioning

confidence: 97%

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Mechanical left ventricular unloading during high risk coronary angioplasty: First use of a new percutaneous transvalvular left ventricular assist device

Scholz

Figulla

Schweda

et al. 1994

Cathet. Cardiovasc. Diagn.

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A new catheter mounted, transvalvular left ventricular assist device has been designed for percutaneous transfemoral access. The device, the Hemopump [14 French (Fr.) outer diameter], is based on a mixed flow rotary pump and is capable of flow rates of 1.5-2.2 l/min. The pump is inserted using a specialized 16 Fr. femoral introducer sheath. The first application of the percutaneous Hemopump in man was performed in two patients with hemodynamic compromise during high risk coronary angioplasty. In these patients, Hemopump support resulted in hemodynamic stabilization (increase in aortic pressure from 60/42 to 87/61 and from 80/60 to 100/70 mm Hg, respectively) and marked left ventricular unloading (decrease in pulmonary capillary wedge pressure from 25 to 10 and from 14 to 10 mm Hg) during balloon inflation. In both patients, percutaneous transluminal coronary angioplasty (PTCA) could be accomplished successfully. Using the system for periods of about 2 hr in each patient, we observed no vascular, hemorrhagic, or embolic complications. In both patients, only a minor increase in both plasma free hemoglobin and lactate dehydrogenase levels was noted. Our preliminary experiences suggest that the percutaneous Hemopump is safe and effective and may be a powerful alternative to other devices used for supported angioplasty.

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Section: Fr Hemopumpo Systemmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Mechanical left ventricular unloading during high risk coronary angioplasty: First use of a new percutaneous transvalvular left ventricular assist device

Scholz

Figulla

Schweda

et al. 1994

Cathet. Cardiovasc. Diagn.

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“…Thus, in combination with modern revascularization techniques, the 21-Fr HP system with its sta bilizing effects on hemodynamics as well as myocardial protective features could promote advances in treatment of cardiogenic shock. Recent clinical trials demonstrated improve ment in the hemodynamic condition of pa tients with shock [13] and improvement in survival of selected patients [14].…”

Section: Hp Left-ventricular Assist In Cardiogenic Shockmentioning

confidence: 99%

“…In clinical trials performed in the United States, the large diameter of the HP prevented successful placement in 23% of patients and thus posed a significant barrier to its clinical use [14], Recently, a newly designed miniatu rized HP system has been developed for per cutaneous access. The system is 14 Fr in outer diameter and is based on a mixed flow rotary pump and capable of flow rates of up to 2.2 liters/min ( fig.…”

Section: New Developmentsmentioning

confidence: 99%

Left-Ventricular Unloading by Transvalvular Axial Flow Pumping in Experimental Cardiogenic Shock and during Regional Myocardial Ischemia

Scholz

Hering²,

Schröder³

et al. 1994

Cardiology

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The efficacy of the transfemoral left-ventricular assist device Hemopump^TM (HP; 21 Fr outer diameter) was examined in experiments with adult sheep in two different models of cardiogenic shock (tachycardia shock; ischemia shock), and during ventricular fibrillation. During tachycardia (high frequency pacing-induced; n = 14), HP assist led to a significant increase in cardiac output (from 2.2 to 2.8 liters/min), mean aortic pressure (from 47.6 to 65.6 mm Hg), and myocardial perfusion pressure (from 25.5 to 59.0 mm Hg). Simultaneously, a normalization of body oxygen-uptake (from 1.4 to 2.5 ml/min·kg), a decrease in myocardial oxygen consumption (from 6.1 to 4.8 ml/min·lOO g), and a normalization of myocardial lactate metabolism were ovserved during HP assist. During regional myocardial ischemia (PTCA balloon occlusion of the proximal LAD (3.5 min; n = 12), HP assist led to significant decrease in LV enddiastolic pressure (from 21.1 to 12.1 mm Hg), and increase in diastolic aortic pressure (from 58 to 67 mm Hg) resulting in significant increase in coronary perfusion pressure. In the early reperfusion period, myocardial release of both lactate and potassium was significantly lowered with HP assist. During ventricular fibrillation (induced by electrical stimulation; n = 9), HP flow rates decreased from 2.5 (after 10 min) to 2.1 liters/min (after 30 min). Mean aortic pressures simultaneously decreased from 64.0 to 54.6 mm Hg. Perfusion conditions were sufficient for maintenance of aerobic myocardial metabolism, but were borderline for peripheral circulation. Our hemodynamic and metabolic data demonstrate beneficial effects of cardiac assist with the Hemopump 21 Fr in both tachycardia-induced severe cardiogenic shock and during acute regional myocardial ischemia. During ventricular fibrillation, flow conditions were sufficient to maintain aerobic myocardial metabolism, but circulatory supply to the total organism was borderline.

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“…Micro-axial blood pumps have been revealed as an useful tool either for short term or for chronic left ventricular assistance [1][2][3][4][5][6][7]. The Hemopump (Medtronic, Minneapolis, USA) is a device based on the principle of the screw pump: it furnishes, by conversion from electric energy, rotating energy to a high speed rotor [8].…”

Section: Introductionmentioning

confidence: 99%

Hydraulic properties of the Hemopump HP31: a study of the downstream pressure distribution

Grigioni

Carotti²,

Daniele

et al.

2001 Conference Proceedings of the 23rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society

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Treatment of cardiogenic shock with the hemopump left ventricular assist device

Cited by 78 publications

References 13 publications

Mechanical left ventricular unloading during high risk coronary angioplasty: First use of a new percutaneous transvalvular left ventricular assist device

Mechanical left ventricular unloading during high risk coronary angioplasty: First use of a new percutaneous transvalvular left ventricular assist device

Left-Ventricular Unloading by Transvalvular Axial Flow Pumping in Experimental Cardiogenic Shock and during Regional Myocardial Ischemia

Hydraulic properties of the Hemopump HP31: a study of the downstream pressure distribution

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