[Partial mechanical cardiac replacement in experimental cardiogenic shock]

The importance to evaluate artificial ventricles for left heart assist under cardiogenic shock conditions is emphasized. The main cardiogenic shock models currently used for assisted circulation research are mentioned. Our own method called selective peripheral coronary embolization is presented in detail with its anatomic, pathologic-histologic and electrocardiographic pattern. Polyester fibrils are embolized selectively to the posterior wall of the heart by direct puncture of the circumflex branch of the left coronary artery. Shock hemodynamics and the effects of circulatory assist by the pneumatically driven ellipsoid ventricle (ELVAD) are demonstrated in 20 acute calf experiments. The artificial ventricle was inserted to the circulation between the natural left ventricle and the thoracic aorta in a paracorporeal and intrathoracic position. ELVAD activation was followed by a significant decrease of left ventricular pressure (-65%) and left atrial pressure (-35%). Cardiac index was increased by 10% and mean aortic pressure by 28% from their shock levels. Hemodynamics in irreversible ventricular fibrillation are analyzed in a calf experiment with a 40 hours survival only with ELVAD assist.