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Biomedical subjects

C Kongtahworn

Publications and source records attributed to C Kongtahworn.

42 records · Page 3Linked to original sources
PubMedDate not supplied

Hemopump support for the failing heart.

Under fluoroscopy, the hemopump is passed through the aortic valve into the left ventricle through a Gortex (WF Gore, Denver, CO) chimney sewn to a surgically exposed femoral artery. The system aspirates the left ventricular blood and actively pumps it into the aorta. Five patients (four men, one woman), aged 47-71 years (mean, 62 years), were candidates for hemopump support because of refractory cardiogenic shock. Three were recovering from repeated coronary artery bypass graft (CABG) surgery, and two required postoperative emergency CABG for failed percutaneous transluminal coronary angioplasty (PTCA). One patient died during insertion, and four had the hemo-pump successfully placed. All patients had low cardiac out-put and had intraaortic balloons in place. Average insertion time took 20 min, with maintenance on the hemopump for an average of 13 hr. One patient was maintained on the hemopump for 12 hr, but because of continued deterioration, was placed on a total artificial heart (Harvik 7-70). Patients 3 (hemopump inserted transthoracically) and 4 had the hemopump discontinued because of brain death, and the fifth survived. This patient is alive and working 1 yr later. The hemopump is an effective left ventricular support system that is less invasive than conventional transthoracic systems.

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PubMedDate not supplied

Bridging circulatory support before heart transplant without invasion of the mediastinum.

Heart transplantation is becoming a useful tool in the clinical treatment of patients with end-stage cardiac decompensation. Donor organs are not always available at a critical time for a patient waiting for a transplant. Bridging techniques have been described that use mechanical support systems. This article describes the use of femoral-venous to femoral-arterial bypass over a period of 50 hours in a 38-year-old woman waiting for a donor heart. Because the patient sustained cardiopulmonary arrest before organ availability, mechanical circulatory support that used femoral-venous to femoral-arterial bypass was instituted. The patient's own lungs were used as an oxygenator. Pump flow levels were determined by the level of central aortic oxygen saturation. Successful transplant was performed, and bridging, therefore, was done without invasion of the mediastinum.

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PubMedDate not supplied

A new left ventricular assist device: clinical experience in two patients.

A permanent parallel aortic pump (PAP), essentially a permanent intra-aortic balloon pump or modified dynamic aortic patch, has been designed to support failing left ventricles The PAP is a counterpulsation system in which an external energy source delivers a pulsatile wave into the central circulation during cardiac diastole and relaxes during cardiac systole. Clinical improvement occurred in two patients after PAP implantation. The initial regimen of continuous pumping evolved to intermittent left ventricular assistance, and the patients were able to be periodically disconnected from the pump and ambulated. The patients expired 39 and 34 days after implantation due to gastrointestinal bleeding and complications of chronic emphysema and tracheostomy. Autopsy revealed that surgery for both devices had entirely healed.

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