sociation, April 11-13, 1991, Boca Raton, Florida. Address reprint ... From the University of Pittsburgh Artificial Heart Program, ..... tractility. Currently we are attempting to use this tech- .... based program that fostered 2 Masters theses, 2 Ph.D.
Evolving Experience
With
Mechanical
Circulatory Support
ROBERT L. KORMOS, M.D., HARVEY S. BOROVETZ, PH.D., JOHN M. ARMITAGE, M.D., ROBERT L. HARDESTY, M.D., GARY C. MARRONE, M.D., and BARTLEY P. GRIFFITH, M.D. From the University of Pittsburgh Artificial Heart Program, Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Since 1985 total mechanical circulatory support for mortally ill transplant candidates has been progressively integrated into the authors' program. During this period 379 patients underwent transplantation. Of this group of patients, 62 required some form of mechanical support other than the intra-aortic balloon pump. Because intra-aortic balloon pump assist was limited in therapeutic effect and was associated with patient immobility and linerelated sepsis, the next logical step toward support was the artificial heart. Of 20 patients implanted with the Jarvik heart, 17 underwent transplantation, but only 9 of these survived to discharge. In 1988, the authors abandoned the preferential use of the total artificial heart because of excessive cumulative probability of death from wound infection. They began to use the Novacor electrical assist device with the percutaneous power cord because they believed that univentricular support would be adequate for most patients, because its heterotopic position would reduce the likelihood of infection, and because it had the potential for chronic implantation. Twenty-three patients with biventricular failure (right ventricular ejection fraction
