Development of Simple and Safe System for Percutaneous Left Heart Bypass

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The main purpose of this research is firstly to develop anew system for percutaneous left heart bypass and secondly to evaluate the utility and safety of this system in clinical patients. In 1992, we developed a system of percutaneous left heart bypass in collaborating with Medikit company (Tokyo, Japan) which consists of a percutaneous left atrial cannula (18Fr.) and a femoral arterial cannula (14Fr.). The left atrial cannula has 20 small holes (phi 1.5mm) within 3.5 cm from the tip of the cannula and angled 60 degree at 50mm from the tip. This system was designed to be set up easily and safely with guidance of transesophageal echocardiography (TEE) using similar technique of Inoue's balloon mitral valuvuloplasty method. To confirm the technical procedure to set up this system we performed several series of animal experiment using dogs. After confirming the ease of set-up procedure and safety of the system, we applied this system for a patient with severe ischemic heart disease and ca … More rdiac failure during percutaneous trans luminal coronary angioplasty in 1992) with complete informed consent of the patient and his family. During the period of 1992 and 1994, we applied this system for 9 patients with cardiogenic shock or severe heart failure. A dramatic recovery of hemodynamic condition was obtained in all patients, however, we lost 6 patients ultimately due to the deterioration of the cardiac function which already existed prior to apply this system. Autopsy demonstrated no complication relating to this system including the the atrial septal punctured site. The TEE guidance requires an additional specialist to operating TEE system and a definite discomfort of the patient, therefore we r introduced intracardiac ultrasound system (ICUS) for the guidance of atrial transseptal puncture for set-up this system in 1994. We could confirm our PLHB system can be set up very easily even in the intensive care unit without X-ray arrangement within very short period with TEE or ICUS guidance. Less