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PubMedDate not supplied

The true value of the carotid steal syndrome after the carotid subclavian by-pass. Human experimental study.

Between 1964 and 1978 sixteen patients underwent a carotid subclavian by-pass in the Akademisch Ziekenhuis of Gent. Most of these patients were submitted to tests to evaluate the importance of the carotid steal effect. The patency of the vertebral artery was found to influence these tests. Two of the three patients with an occluded vertebral artery had cerebral symptoms when the peripheral resistance was lowered in the involved limb. No positive tests could be found in the twelve patients with a patient vertebral artery. These results indicate that the carotid subclavian artery by-pass performed in the presence of an occluded vertebral artery does not protect the patient from the carotid steal effect.

Adult↗

PubMedDate not supplied

Hemopump fails as bridge to transplantation in postinfarction ventricular septal defect.

From 1990, six patients were bridged to transplantation with a catheter-mounted axial flow pump (Hemopump). Indications were graft failure (two patients), postinfarction ventricular septal defect (two patients), myocarditis (1 patient), and myocardial infarction (1 patient). The 21F cannula, inserted via the groin, was used as a partial assist in four patients, and the 31F cannula, inserted via the ascending aorta, was used to assist the other two patients completely. Hemodynamic recovery was achieved in all patients (mean cardiac index rose from 2.1 L/gm/m2 to 3.85 L/gm/m2 after 1 hour assist). Sudden pump failure occurred in the two patients with postinfarction ventricular septal defect and a piece of necrotic tissue blocking the catheter was found. Both patients died. The other four patients were successfully bridged to transplantation. One of these patients died during his postoperative hospital stay; the three remaining patients were discharged and were well at follow-up (46, 40, and 3 months). The Hemopump device provides sufficient organ perfusion to be used as a bridge to transplantation. No conclusions can be drawn for the long-term use (longest run in this series was 102 hours). Postinfarction ventricular septal defect is a contraindication for the use of the Hemopump device.

Adolescent↗